Dental Park Sc is a Dental in Manitowoc, Wisconsin. Dental Park Sc practices all healthcare services and medical treatments related to Dental. The NPI Number for Dental Park Sc is 1386636959. The last update date is 2022-07-21.
Dental Park Sc's current location address is 1503 Randolph Ct, Manitowoc, Wisconsin. You can contact this provider via phone number 9206820321 and fax number 9206823128. The mailing address for Dental Park Sc is 1503 Randolph Ct, Manitowoc, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dental Park Sc |
|---|---|
| Address | 1503 Randolph Ct, Manitowoc, Wisconsin |
| Phone Number | 9206820321 |
| Fax Number | 9206823128 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PARTNER SE |
|---|---|
| Authorized Official Name | Boettcher Robert Daniel |
| Credentials | DDS |
| Telephone Number | 9206820321 |
NPI Number Detail
| NPI Number | 1386636959 |
|---|---|
| Provider Enumeration Date | 2005-08-18 |
| Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
| Address | 1503 Randolph Ct |
|---|---|
| City | Manitowoc |
| State | Wisconsin (WI) |
| Post Code | 542208345 |
| Phone Number | 9206820321 |
| Fax Number | 9206823128 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Dental Park Sc by the Centers for Medicare & Medicaid Services?
The Dental Park Sc has been assigned the NPI (National Provider Identifier) 1386636959 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Dental Park Sc?
The Dental Park Sc is physically situated at 1503 Randolph Ct, in the city of Manitowoc, state of WI, with the postal code 542208345.
What is the area of specialization for Dental Park Sc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Dental Park Sc is Dental, and the corresponding taxonomy code that categorizes this area of expertise is 261Qd0000X.
On what date did Dental Park Sc receive its 1386636959 assignment from the Centers for Medicare & Medicaid Services?
The Dental Park Sc was assigned its 1386636959 on 2005-08-18, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Dental Park Sc most recently updated or revised?
The information pertaining to Dental Park Sc, including its address, specialty, and other relevant details, was last updated or revised on 2022-07-21.