Organization
FOX RIVER DENTAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MATTICE (OFFICE MANAGER)
(920) 361-3080
Entity
Organization
Contact information
Practice address
120 COMMERCIAL ST, BERLIN, WI 54923-1737
(920) 361-3080
(920) 361-3083
Mailing address
PO BOX 45, BERLIN, WI 54923-0045
(920) 361-3080
(920) 361-3083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000722015
WI
Other
Enumeration date
01/26/2007
Last updated
03/10/2008
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