Organization
UNIVERISTY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL E TACHE D.M.D.,F.A.G.D. (OWNER)
(920) 437-7444
Entity
Organization
Contact information
Practice address
1833 UNIVERSITY AVE, GREEN BAY, WI 54302-3637
(920) 437-7444
(920) 437-7862
Mailing address
1833 UNIVERSITY AVE, GREEN BAY, WI 54302-3637
(920) 437-7444
(920) 437-7862
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5089-015
MA
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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