Modern Dental Center LLC
NPI #1689320897 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1689320897
- Entity Type
- Organization
- Organization Name
- Modern Dental Center LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Feb 25, 2022
- Last Updated
- Feb 25, 2022
Practice Location
- Address
- 101 CAMELOT DR STE 3
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54935-8048
- Phone
- (920) 921-1244
Authorized Official
- Name
- MICHAEL COLE
- Title
- VP INSURANCE PLAN MANAGEMENT
- Phone
- (727) 424-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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