| NPI | 1386161420 |
|---|---|
| Doing Business As | FORT FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SARA PODOLL Dentist 920-563-4322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-07-21 |