Quirt Family Dentistry, Sc

NPI #1700251725 in Fitchburg, Wisconsin

Provider Information

NPI Number: 1700251725
Entity Type: Organization
Organization Name: Quirt Family Dentistry, Sc
Subpart: Yes (part of a larger organization)
Parent Organization: QUIRT FAMILY DENTISTRY, SC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 2, 2015
Last Updated: Dec 29, 2015

Practice Location

Address: 5401 CADDIS BND
Address 2: UNIT B
City: Fitchburg
State: Wisconsin
ZIP Code: 53711-7122
Phone: (608) 807-1543

Authorized Official

Name: KENDRA WALKER
Title: CREDENTIALING TEAM LEAD
Phone: (217) 540-8312

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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