Organization
SHEBOYGANCTD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH WEILAND (ASSISTANT CONTROLLER)
(608) 343-0818
Entity
Organization
Contact information
Practice address
1407 N 8TH ST STE 201, SHEBOYGAN, WI 53081-3400
(920) 458-3746
Mailing address
8025 EXCELSIOR DR, MADISON, WI 53717-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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