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General NPI Number Information
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NPI Number | 1194241216
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Entity Type | Organization
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Legal Business Name | NORTH APPLETON DENTISTRY, LLC
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 3521 COMMERCE CT
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City | APPLETON
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State | WI
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Zip | 54911-8579
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Country | US
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Telephone | 920-734-7730
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Fax |
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Provider Business Mailing Address
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Address Line | W5840 GERANIUM DR
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City | APPLETON
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State | WI
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Zip | 54915-5662
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Country | US
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Telephone | 920-954-8216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA KATZENMAIER
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Credential | RDH
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Telephone | 920-734-7730
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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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