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)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Berlin, WI

All providers in Berlin, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.