Organization
QUIRT FAMILY DENTISTRY, SC
Active
Parent organization
QUIRT FAMILY DENTISTRY, SC
Other names
Quirt Family Dentistry - Edgar
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUIRT FAMILY DENTISTRY, SC
Authorized official
KIM WILSON (CREDENTIALING COORDINATOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
107 S 3RD AVE, EDGAR, WI 54426-9282
(715) 352-3800
Mailing address
107 S 3RD AVE, EDGAR, WI 54426-9282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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