201 Water Front Dental LLC
NPI #1902912165 in Fort Atkinson, Wisconsin
Provider Information
- NPI Number
- 1902912165
- Entity Type
- Organization
- Organization Name
- 201 Water Front Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 21, 2006
- Last Updated
- Nov 27, 2024
Practice Location
- Address
- 201 SHERMAN AVE. W.
- City
- Fort Atkinson
- State
- Wisconsin
- ZIP Code
- 53538
- Phone
- (920) 563-7323
Authorized Official
- Name
- MICHAEL A BENDER, DDS
- Title
- 1ST VICE PRESIDENT
- Phone
- (920) 563-7323
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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