Organization
EBY FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY A. EBY D.D.S. (DENTIST/OWNER)
(920) 563-2928
Entity
Organization
Contact information
Practice address
715 SHERMAN AVE EAST, FORT ATKINSON, WI 53538
(920) 563-2928
(920) 563-6585
Mailing address
715 SHERMAN AVE EAST, FORT ATKINSON, WI 53538
(920) 563-2928
(920) 563-6585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5909-015
WI
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
09/02/2008
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