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General NPI Number Information
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NPI Number | 1003796285
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Entity Type | Organization
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Legal Business Name | DENTISTRY WITH DR M LLC
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 105 WARREN ST STE 2
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City | BEAVER DAM
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State | WI
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Zip | 53916-3012
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Country | US
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Telephone | 262-833-7362
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Fax |
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Provider Business Mailing Address
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Address Line | 105 WARREN ST STE 2
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City | BEAVER DAM
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State | WI
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Zip | 53916-3012
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Country | US
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Telephone | 920-887-1432
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. NIDHI MAHAJAN
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Credential | DMD
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Telephone | 920-887-1432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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