Organization
KIEL FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY FURDEK D.D.S. (OWNER / DENTIST)
(920) 898-2305
Entity
Organization
Contact information
Practice address
403 FREMONT ST, KIEL, WI 53042-1316
(920) 898-2305
(920) 894-3048
Mailing address
403 FREMONT ST, KIEL, WI 53042-1316
(920) 898-2305
(920) 894-3048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6322-15
WI
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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