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Organization

QUIRT FAMILY DENTISTRY, SC

Active
Parent organization
QUIRT FAMILY DENTISTRY, SC
Other names
Gateway Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
QUIRT FAMILY DENTISTRY, SC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization

Contact information

Practice address
2777 MILWAUKEE RD, BELOIT, WI 53511
(608) 312-2945
Mailing address
2777 MILWAUKEE RD, BELOIT, WI 53511

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
06/18/2014
Last updated
06/18/2014
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