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Organization
FOND DU LAC FAMILY DENTISTRY, LLC
Active
Organization
FOND DU LAC FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL STEVENS DDS (OWNER/DENTIST)
(920) 922-9000
Entity
Organization
Contact information
Practice address
145 S MARR ST STE 1, FOND DU LAC, WI 54935-4419
(920) 922-9000
Mailing address
145 S MARR ST STE 1, FOND DU LAC, WI 54935-4419
(920) 922-9000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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