Bay Park Smiles LLC

NPI #1104543065 in Green Bay, Wisconsin

Provider Information

NPI Number: 1104543065
Entity Type: Organization
Organization Name: Bay Park Smiles LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 21, 2022
Last Updated: Oct 21, 2022

Practice Location

Address: 1052 BEL AIRE CT
City: Green Bay
State: Wisconsin
ZIP Code: 54304-5015
Phone: (920) 499-2121

Authorized Official

Name: AARON BUSHONG
Title: DENTIST/OWNER
Phone: (715) 573-3546

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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