NPI | 1063775377 |
---|---|
Doing Business As | ADVANCED CARE SMILE CENTER OF APPLETON |
Entity Type | Organization |
Authorized Contact | REBECCA LYNN BERGENE Chief Operating Officer 920-860-9252 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2012-06-21 |
Last Update Date | 2012-06-21 |