Quirt Family Dentistry, Sc

NPI #1922442300 in Appleton, Wisconsin

Provider Information

NPI Number: 1922442300
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: Apr 29, 2013
Last Updated: Apr 29, 2013

Practice Location

Address: 3813 E CALUMET ST
City: Appleton
State: Wisconsin
ZIP Code: 54915-4158
Phone: (920) 931-4505

Authorized Official

Name: KIM WILSON
Title: CREDENTIALING SUPERVISOR
Phone: (217) 540-5170

Specialties & Taxonomy Codes

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

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