Organization
ALLOUEZ FAMILY DENTAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL A KOLLATH DDS (PRESIDENT)
(920) 339-8980
Entity
Organization
Contact information
Practice address
2805 LIBAL ST, STE C, GREEN BAY, WI 54301-2788
(920) 339-8980
(920) 339-0133
Mailing address
2805 LIBAL ST, STE C, GREEN BAY, WI 54301-2877
(920) 339-0133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1857-G
WI
Other
Enumeration date
10/27/2006
Last updated
08/22/2020
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