Individual
DR. HARVEY DENNIS POLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
1458 SUNDANCER LN, KEWAUNEE, WI 54216-1917
(920) 388-3005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5320-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33765300
—
WI
01
—
4044
DENTAL LICENSE
NE
Enumeration date
08/21/2006
Last updated
07/08/2007
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