Organization
HEALTHY TEETH GREEN BAY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL RAZO (CREDENTIALING)
(623) 434-9343
Entity
Organization
Contact information
Practice address
2324 OLD PLANK RD, DE PERE, WI 54115-8618
(623) 434-9343
(623) 321-6268
Mailing address
1904 W PARKSIDE LN, SUITE 201, PHOENIX, AZ 85027-1228
(623) 434-9343
(623) 321-6268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/22/2006
Last updated
08/22/2020
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