Organization
QUIRT FAMILY DENTISTRY, SC
Active
Parent organization
QUIRT FAMILY DENTISTRY, SC
Other names
Quirt Family Dentistry - Wausau
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUIRT FAMILY DENTISTRY, SC
Authorized official
KIM WILSON (CREDENTIALING COORDINATOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
200 E BRIDGE ST, SUITE 100, WAUSAU, WI 54403-3574
(715) 843-9800
Mailing address
200 E BRIDGE ST, SUITE 100, WAUSAU, WI 54403-3574
(715) 843-9800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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