Organization
EBY FAMILY DENTAL OF JEFFERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA L RENDON (INSURANCE COORDINATOR)
(920) 563-2928
Entity
Organization
Contact information
Practice address
1491 S MAIN ST, JEFFERSON, WI 53549-2931
(920) 563-2928
(920) 897-6081
Mailing address
PO BOX 299, JEFFERSON, WI 53549-0299
(920) 563-2928
(920) 897-6081
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/11/2023
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