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General NPI Number Information
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NPI Number | 1013837012
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Entity Type | Organization
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Legal Business Name | MEQUON DENTAL ARTS LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 10033 N PT WASHINGTON RD STE 150
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City | MEQUON
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State | WI
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Zip | 53092-5761
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Country | US
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Telephone | 262-241-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 10033 N PT WASHINGTON RD STE 150
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City | MEQUON
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State | WI
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Zip | 53092-5761
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Country | US
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Telephone | 262-241-5558
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MR. DAVID MICHAEL GLINCHER
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Credential |
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Telephone | 262-241-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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