Vanderleest Dental LLC

NPI #1194460162 in Green Bay, Wisconsin

Provider Information

NPI Number: 1194460162
Entity Type: Organization
Organization Name: Vanderleest Dental LLC
Primary Specialty: Dentist
Enumeration Date: May 3, 2022
Last Updated: May 3, 2022

Practice Location

Address: 2502 LINEVILLE RD
City: Green Bay
State: Wisconsin
ZIP Code: 54313-7123
Phone: (920) 434-3950

Authorized Official

Name: MARCUS J VANDERLEEST, DDS
Title: OWNER
Phone: (920) 434-3950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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