Organization
BAY DENTAL ASSOCIATES OF GREEN BAY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOHN NOCKERTS D.D.S. (PRESIDENT)
(920) 469-8484
Entity
Organization
Contact information
Practice address
2460 FINGER RD, GREEN BAY, WI 54302-4210
(920) 469-8484
(920) 469-8486
Mailing address
2460 FINGER RD, GREEN BAY, WI 54302-4210
(920) 469-8484
(920) 469-8486
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38361000
—
WI
Enumeration date
08/30/2006
Last updated
08/22/2020
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