Organization
CHARLES E. MONTOURE, DDS, MS MARK H HANSON, DDS, MS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E MONTOURE DDS MS (PRESIDENT OF CORP)
(920) 499-3721
Entity
Organization
Contact information
Practice address
2000 SHADY LANE, GREEN BAY, WI 54313-9311
(920) 499-3721
(920) 499-7502
Mailing address
2000 SHADY LANE, GREEN BAY, WI 54313-9311
(920) 499-3721
(920) 499-7502
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
05/31/2007
Last updated
07/25/2008
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