Healthcare Provider Details

I. General information

NPI: 1073825246
Provider Name (Legal Business Name): RACHEL L ARTS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5553 W WATERFORD LN
APPLETON WI
54913-8468
US

IV. Provider business mailing address

5553 W WATERFORD LN
APPLETON WI
54913-8468
US

V. Phone/Fax

Practice location:
  • Phone: 920-739-7165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6558-015
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: