Organization
TIMBERCREST DENTAL CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BERTON LUTHER D.D.S. (PRESIDENT)
(920) 734-9148
Entity
Organization
Contact information
Practice address
821 E 1ST AVE, SUITE 3, APPLETON, WI 54911-1501
(920) 734-9148
(920) 734-8710
Mailing address
821 E 1ST AVE, SUITE 3, APPLETON, WI 54911-1501
(920) 734-9148
(920) 734-8710
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5588-015
WI
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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