Organization
FAMILY DENTAL CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ELLEN SEIDL (BUSINESS ASSISTANT)
(920) 684-8033
Entity
Organization
Contact information
Practice address
3712 KADOW ST, MANITOWOC, WI 54220-5450
(920) 684-8033
(920) 684-6360
Mailing address
3712 KADOW ST, MANITOWOC, WI 54220-5450
(920) 684-8033
(920) 684-6360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3890
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38393000
—
WI
Enumeration date
11/29/2006
Last updated
08/22/2020
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