Mdc Bellevue, L.l.c.

NPI #1396105474 in Green Bay, Wisconsin

Provider Information

NPI Number: 1396105474
Entity Type: Organization
Organization Name: Mdc Bellevue, L.l.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 2, 2016
Last Updated: Mar 2, 2016

Practice Location

Address: 2040 CENTRAL CT
City: Green Bay
State: Wisconsin
ZIP Code: 54311-6276
Phone: (920) 468-0504

Authorized Official

Name: DR. WILLIAM C MAUTHE III, D.D.S.
Title: OWNER
Phone: (920) 921-1244

Specialties & Taxonomy Codes

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

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