| NPI | 1225525959 |
|---|---|
| Other Name | TIMBERCREEK SMILES |
| Entity Type | Organization |
| Authorized Contact | REBECCA P VANMILLER Owner 920-366-5068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 15-5497) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: WI 1001549-15) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |