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Organization

QUIRT FAMILY DENTISTRY, SC

Active
Parent organization
QUIRT FAMILY DENTISTRY, SC
Other names
Smiles on Calumet
Organization subpart
Yes

Provider details

NPI number
Legal business name
QUIRT FAMILY DENTISTRY, SC
Authorized official
KIM WILSON (CREDENTIALING SUPERVISOR)
(217) 540-5170
Entity
Organization

Contact information

Practice address
3813 E CALUMET ST, APPLETON, WI 54915-4158
(920) 931-4505
Mailing address
3813 E CALUMET ST, APPLETON, WI 54915-4158
(920) 931-4505

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
04/29/2013
Last updated
04/29/2013
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