Organization
TRI-COUNTY COMMUNITY DENTAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY DREXLER (EXECUTIVE DIRECTOR)
(920) 882-9989
Entity
Organization
Contact information
Practice address
9 TRI PARK WAY, APPLETON, WI 54914-1661
(920) 882-9989
(920) 882-9961
Mailing address
9 TRI PARK WAY, APPLETON, WI 54914-1661
(920) 882-9989
(920) 882-9961
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38392800
—
WI
Enumeration date
10/11/2006
Last updated
08/25/2022
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