Racine Tooth Town Dentistry for Kids

NPI #1427610179 in Racine, Wisconsin

Provider Information

NPI Number: 1427610179
Entity Type: Organization
Organization Name: Racine Tooth Town Dentistry for Kids
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jul 2, 2019
Last Updated: Jul 2, 2019

Practice Location

Address: 3801 WASHINGTON AVE
City: Racine
State: Wisconsin
ZIP Code: 53405-2853
Phone: (414) 949-1938

Authorized Official

Name: NATHAN HENRY KNUTSEN, DDS
Title: OWNING DENTIST
Phone: (414) 797-0328

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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