East Troy Family Dental Center Sc

NPI 1376607408 - Clinic/Center - 261QD0000X

NPI Details
NPI 1376607408
Enumeration Date 12/21/2006
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GREGORY A GREGORY
Position OWNER PRESIDENT
Phone (262) 642-5695
Fax (262) 642-5395
Practice Location
2481 EXECUTIVE DR
EAST TROY WI, 53120, US
Phone (262) 642-5695
Fax (262) 642-5395
Business Location
PO BOX 642
EAST TROY WI, 53120, US
Phone (262) 642-5695
Fax (262) 642-5395
Toxanomy
Taxonomy Code 261QD0000X
License State
License Number
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According to our database, East Troy Family Dental Center Sc NPI is 1376607408, taxonomy code is 261QD0000X East Troy Family Dental Center Sc physically located at 2481 Executive Dr, East Troy WI, 53120. NPI Number 1033115704 has the healthcare provider type.

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1376607408 NPI number is provided on an as is basis without warranty of any kind. 1376607408 is maintained by the National Plan & Provider Enumeration System. The contents of East Troy Family Dental Center Sc are for informational purposes only.