Organization
LA PETITE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDY MANCINI DMD, MBA (OWNER/PRESIDENT)
(855) 527-3848
Entity
Organization
Contact information
Practice address
131 CARMICHAEL RD STE 200, HUDSON, WI 54016-8271
(855) 527-3848
(855) 457-3329
Mailing address
131 CARMICHAEL RD STE 200, HUDSON, WI 54016-8271
(855) 527-3848
(855) 457-3329
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6499-015
WI
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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