Organization
CHILDREN'S DENTAL CENTER S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP ANDREW BAKER D.D.S. (PRESIDENT)
(920) 233-1030
Entity
Organization
Contact information
Practice address
230 N SAWYER ST, OSHKOSH, WI 54902-4280
(920) 233-1030
(920) 233-7398
Mailing address
230 N SAWYER ST, OSHKOSH, WI 54902-4280
(920) 233-1030
(920) 233-7398
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4436-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33720600
—
WI
Enumeration date
09/18/2008
Last updated
09/18/2008
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