Children'S Dental Center S.C.
Organization Active NPI Dental Clinic/Center · Oshkosh, WI
NPI 1730339367 · NPPES record last updated Sep 18, 2008
Key facts
- NPI
- 1730339367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 4436-015 (WI)
- Legal business name
- CHILDREN'S DENTAL CENTER S.C.
- Practice address
- 230 N Sawyer St
Oshkosh, WI 54902-4280 - Phone
- (920) 233-1030
- Fax
- (920) 233-7398
- NPI assigned
- Sep 18, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Phillip Andrew Baker, D.D.S.
- Title
- President
- Phone
- (920) 233-1030
Practitioners 2
-
Phillip Andrew Baker, D.D.S.
National Provider Directory
Locations
230 N Sawyer St
Oshkosh, WI 54902
Phone (920) 233-1030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 4436-015 | WI | Yes |
Addresses
Primary practice location
230 N Sawyer St
Oshkosh, WI 54902-4280
Mailing address
230 N Sawyer St
Oshkosh, WI 54902-4280
Phone (920) 233-1030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33720600 | Medicaid | WI |
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All providers in Oshkosh, WI · Dental Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 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.