Quirt Family Dentistry, Sc

NPI #1124569181 in Grafton, Wisconsin

Provider Information

NPI Number: 1124569181
Entity Type: Organization
Organization Name: Quirt Family Dentistry, Sc
Subpart: Yes (part of a larger organization)
Parent Organization: QUIRT FAMILY DENTISTRY, SC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 10, 2017
Last Updated: Mar 10, 2017

Practice Location

Address: 1580 PORT WASHINGTON ROAD
City: Grafton
State: Wisconsin
ZIP Code: 53024
Phone: (262) 671-1969

Authorized Official

Name: KENDRA WALKER
Title: CREDENTIALING SUPERVISOR
Phone: (217) 540-8312

Specialties & Taxonomy Codes

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

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