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Organization
EAST TROY FAMILY DENTAL CENTER SC
Active
Organization
EAST TROY FAMILY DENTAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY A NYFFELER DDS (OWNER PRESIDENT)
(262) 642-5695
Entity
Organization
Contact information
Practice address
2481 EXECUTIVE DR, EAST TROY, WI 53120
(262) 642-5695
(262) 642-5395
Mailing address
PO BOX 642, EAST TROY, WI 53120
(262) 642-5695
(262) 642-5395
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38368500
—
WI
Enumeration date
12/21/2006
Last updated
08/22/2020
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