Organization
AFFORDABLE DENTURES - EAU CLAIRE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP DOUGLAS DDS (PRACTICE OWNER)
(715) 855-1020
Entity
Organization
Contact information
Practice address
4850 KEYSTONE XING, EAU CLAIRE, WI 54701-5076
(715) 855-1020
Mailing address
4850 KEYSTONE XING, EAU CLAIRE, WI 54701-5076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6330-015
WI
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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