Dental Assosiates
NPI #1558710269 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1558710269
- Entity Type
- Organization
- Organization Name
- Dental Assosiates
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jun 3, 2016
- Last Updated
- May 8, 2019
Practice Location
- Address
- 545 E JOHNSON ST
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54935-2856
- Phone
- (920) 924-9090
Authorized Official
- Name
- MRS. MARLEY BRAKER
- Title
- PROVIDER CREDENTIALING SPECIALIST
- Phone
- (414) 808-3031
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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