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Organization
ADVANCED DENTAL CARE CLINIC SC
Active
Organization
ADVANCED DENTAL CARE CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOOMAN SERESHKI DDS (OWNER)
(920) 892-8466
Entity
Organization
Contact information
Practice address
62 S PLEASANT VIEW ROAD, PLYMOUTH, WI 53073
(920) 892-8466
Mailing address
62 S PLEASANT VIEW RD, PLYMOUTH, WI 53073-4954
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
12/13/2019
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