Organization
QUIRT FAMILY DENTISTRY, S.C.
Active
Parent organization
QUIRT FAMILY DENTISTRY, S.C.
Other names
Lakefront Pediatric Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUIRT FAMILY DENTISTRY, S.C.
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING)
(217) 764-8609
Entity
Organization
Contact information
Practice address
135 CAPITOL DR, PEWAUKEE, WI 53072-2401
(262) 701-8012
(262) 701-8011
Mailing address
135 CAPITOL DR, PEWAUKEE, WI 53072-2401
(262) 701-8012
(262) 701-8011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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