Boys and Girls Club of Portage County
NPI #1962916650 in Stevens Point, Wisconsin
Provider Information
- NPI Number
- 1962916650
- Entity Type
- Organization
- Organization Name
- Boys and Girls Club of Portage County
- Primary Specialty
- Dental Hygienist
- Enumeration Date
- Nov 17, 2017
- Last Updated
- Nov 17, 2017
Practice Location
- Address
- 941 MICHIGAN AVE
- City
- Stevens Point
- State
- Wisconsin
- ZIP Code
- 54481
- Phone
- (715) 204-1180
Authorized Official
- Name
- MELISSA GUTIERREZ, RDH
- Title
- SMILE CLUB COORDINATOR
- Phone
- (715) 204-1180
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Hygienist |
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