Univeristy Dental LLC

NPI #1538232202 in Green Bay, Wisconsin

Provider Information

NPI Number: 1538232202
Entity Type: Organization
Organization Name: Univeristy Dental LLC
Primary Specialty: Dentist
Enumeration Date: Nov 17, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1833 UNIVERSITY AVE
City: Green Bay
State: Wisconsin
ZIP Code: 54302-3637
Phone: (920) 437-7444

Authorized Official

Name: DR. DANIEL E TACHE, D.M.D.,F.A.G.D.
Title: OWNER
Phone: (920) 437-7444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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