Organization
NEW LONDON FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA THORPE (OFFICE MANAGER)
(920) 982-3567
Entity
Organization
Contact information
Practice address
105 NORTH RIDGE DR, NEW LONDON, WI 54961-5496
(920) 982-3567
Mailing address
105 NORTHRIDGE DR, NEW LONDON, WI 54961-2703
(920) 982-3567
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2018
Last updated
06/12/2020
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