Organization
SCION DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A SWEENEY (CFO/SECRETARY/TREASURER)
(262) 834-6130
Entity
Organization
Contact information
Practice address
10201 N PORT WASHINGTON RD, MEQUON, WI 53092-5752
(262) 834-6130
(866) 413-6397
Mailing address
10201 N PORT WASHINGTON RD, MEQUON, WI 53092-5752
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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