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General NPI Number Information
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NPI Number | 1457492282
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Entity Type | Organization
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Legal Business Name | BARTON DENTAL CLINIC SC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1542 BARTON AVE
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City | WEST BEND
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State | WI
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Zip | 53090
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Country | US
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Telephone | 262-306-9703
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Fax | 262-306-9732
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Provider Business Mailing Address
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Address Line | 1542 BARTON AVE
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City | WEST BEND
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State | WI
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Zip | 53090
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Country | US
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Telephone | 262-306-9703
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Fax | 262-306-9732
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANN C NGUYEN
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Credential |
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Telephone | 262-306-9703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4575
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License Number State | WI
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