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Organization
MENNONITE DENTAL CLINIC
Active
Organization
MENNONITE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRVIN SHIRK (MANAGER)
(715) 669-3790
Entity
Organization
Contact information
Practice address
W8180 COUNTY ROAD X, THORP, WI 54771-7512
(715) 669-3790
Mailing address
W8180 COUNTY ROAD X, THORP, WI 54771-7512
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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