Organization
GREEN BAY FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEIDI EGGERS-ULVE DDS, MS (MEMBER)
(920) 432-2961
Entity
Organization
Contact information
Practice address
2609 DEVELOPMENT DR., GREEN BAY, WI 54311
(920) 432-2961
Mailing address
2609 DEVELOPMENT DR., GREEN BAY, WI 54311
(920) 432-2961
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4264
WI
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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