Individual
DR. PAUL S MANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
152 WOODLAWN DR, SHAWANO, WI 54166-2200
(715) 526-3314
Mailing address
PO BOX 270, SHAWANO, WI 54166-0270
(715) 526-3314
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6814-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144684002
1144684002
WI
05
—
1144684002
—
WI
Enumeration date
11/30/2011
Last updated
02/03/2022
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