Organization
ADVANCED FAMILY DENTISTRY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN SHERRY (FINANCIAL COORDINATOR)
(920) 261-0588
Entity
Organization
Contact information
Practice address
123 HOSPITAL DR, SUITE 201, WATERTOWN, WI 53098-3331
(920) 261-0588
(920) 261-0640
Mailing address
123 HOSPITAL DR, SUITE 201, WATERTOWN, WI 53098-3331
(920) 261-0588
(920) 261-0640
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33741400
—
WI
Enumeration date
06/01/2009
Last updated
01/11/2012
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