# JUST KIDS DENTAL SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518972389
- **Authorized official:** JAIME K MARCHI DDS (PRESIDENT)
- **Authorized official phone:** (920) 452-7336

## Contact information

- **Practice address:** 1313 N TAYLOR DR, SHEBOYGAN, WI 53081-3041
- **Practice address phone:** (920) 452-7336
- **Practice address fax:** (920) 453-9770
- **Mailing address:** 1313 N TAYLOR DR, SHEBOYGAN, WI 53081-3041
- **Mailing address phone:** (920) 452-7336
- **Mailing address fax:** (920) 453-9770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 5236015 | WI | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 12/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33762400 | — | WI |