Fox River Dental Associates SC
Organization Active NPI General Practice Dentistry · Berlin, WI
NPI 1629124375 · NPPES record last updated Mar 10, 2008
Key facts
- NPI
- 1629124375
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5000722015 (WI)
- Legal business name
- FOX RIVER DENTAL ASSOCIATES SC
- Practice address
- 120 Commercial St
Berlin, WI 54923-1737 - Phone
- (920) 361-3080
- Fax
- (920) 361-3083
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Sharon Mattice
- Title
- Office Manager
- Phone
- (920) 361-3080
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 5000722015 | WI | Yes |
Addresses
Primary practice location
120 Commercial St
Berlin, WI 54923-1737
Mailing address
PO Box 45
Berlin, WI 54923-0045
Phone (920) 361-3080
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All providers in Berlin, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.