Organization
MDC MANITOWOC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C MAUTHE III D.D.S. (OWNER)
(920) 921-1244
Entity
Organization
Contact information
Practice address
33 E WALDO BLVD, MANITOWOC, WI 54220-2900
(920) 682-0115
Mailing address
54 E 1ST ST, FOND DU LAC, WI 54935-4204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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