Organization
PARK PLACE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
1551 PARK PL, SUITE 300, GREEN BAY, WI 54304-1982
(920) 497-8500
(920) 497-3213
Mailing address
1551 PARK PL, SUITE 300, GREEN BAY, WI 54304-1982
(920) 497-8500
(920) 497-3213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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