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Organization
GREAT BLUE DENTAL, LLC
Active
Organization
GREAT BLUE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYN STECKBAUER DMD (OWNER)
(920) 235-3251
Entity
Organization
Contact information
Practice address
2005 MARINETTE AVE, MARINETTE, WI 54143-3864
(715) 732-2601
Mailing address
2005 MARINETTE AVE, MARINETTE, WI 54143-3864
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5396-15
WI
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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