Organization
MID-TOWNE DENTAL ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E MCGRATH D.D.S. (OWNER)
(715) 423-3322
Entity
Organization
Contact information
Practice address
1730 7TH ST S, WISCONSIN RAPIDS, WI 54494-5238
(715) 423-3322
(715) 424-3786
Mailing address
1730 7TH ST S, P.O. BOX 1178, WISCONSIN RAPIDS, WI 54494-5238
(715) 423-3322
(715) 424-3786
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001043
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38378500
—
WI
Enumeration date
03/13/2007
Last updated
08/22/2020
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