Organization
FORT FAMILY DENTAL CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LUISIER D.D.S. (PRESIDENT)
(920) 563-4322
Entity
Organization
Contact information
Practice address
715 SHERMAN AVE E, FORT ATKINSON, WI 53538-1992
(920) 563-4322
(920) 563-6585
Mailing address
715 SHERMAN AVE E, FORT ATKINSON, WI 53538-1992
(920) 563-4322
(920) 563-6585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2255
WI
Other
Enumeration date
08/18/2006
Last updated
08/20/2008
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