Organization
MIDWEST ORAL HEALTH, LLC
Active
Other names
Doty Island Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN JAMES MICK DDS (GENERAL DENTIST)
(920) 725-4307
Entity
Organization
Contact information
Practice address
151 E FOREST AVE, NEENAH, WI 54956-2758
(920) 725-4307
Mailing address
151 E FOREST AVE, NEENAH, WI 54956-2758
(920) 725-4307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6961-15
WI
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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