Organization
CRYSTAL RIVER DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY A BELLINGER (OPERATIONS MANAGER)
(616) 450-9270
Entity
Organization
Contact information
Practice address
400 SCHOOL ST, WAUPACA, WI 54981-1626
(616) 450-9270
Mailing address
400 SCHOOL ST, WAUPACA, WI 54981-1626
(616) 450-9270
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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