Organization
MENASHA FAMILY DENTAL LLC
Active
Other names
DePas Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH WEILAND (SENIOR ACCOUNTANT)
(608) 343-0818
Entity
Organization
Contact information
Practice address
1431 PROVINCE TER, MENASHA, WI 54952-7003
(920) 968-1900
Mailing address
1431 PROVINCE TER, MENASHA, WI 54952-7003
(920) 968-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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