Organization
KIRK FISHBAUGH DENTISTRY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRK RICHARD FISHBAUGH D.D.S. (PRESIDENT)
(920) 434-1515
Entity
Organization
Contact information
Practice address
2625 TULIP LN, GREEN BAY, WI 54313-6855
(920) 434-1515
Mailing address
2625 TULIP LN, GREEN BAY, WI 54313-6855
(920) 434-1515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4714-015
WI
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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