Mdc Sun Prairie LLC
NPI #1417330945 in Sun Prairie, Wisconsin
Provider Information
- NPI Number
- 1417330945
- Entity Type
- Organization
- Organization Name
- Mdc Sun Prairie LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jul 1, 2015
- Last Updated
- Jul 1, 2015
Practice Location
- Address
- 1460 W MAIN ST
- City
- Sun Prairie
- State
- Wisconsin
- ZIP Code
- 53590-1846
- Phone
- (608) 837-4636
Authorized Official
- Name
- DR. WILLIAM C MAUTHE III, D.D.S.
- Title
- OWNER
- Phone
- (920) 921-1244
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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