Organization
MAURY FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS MAURY (OWNER)
(920) 921-6260
Entity
Organization
Contact information
Practice address
145 S MARR ST, FOND DU LAC, WI 54935-4408
(920) 921-6260
Mailing address
145 S MARR ST, FOND DU LAC, WI 54935-4408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5369015
WI
332BC3200X
Customized Equipment (DME)
5369015
WI
Other
Enumeration date
09/22/2015
Last updated
10/07/2015
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