Organization
MCBRIDE DENTAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY M MCBRIDE DDS (OWNER)
(920) 922-9400
Entity
Organization
Contact information
Practice address
336 HARBOR VIEW DR, FOND DU LAC, WI 54935
(920) 922-9400
(920) 921-3260
Mailing address
336 HARBOR VIEW DR, FOND DU LAC, WI 54935
(920) 922-9400
(920) 921-3260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33490200
—
WI
Enumeration date
08/31/2006
Last updated
08/22/2020
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