| NPI | 1891178877 |
|---|---|
| Doing Business As | FORT DENTAL CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | JOSEPH A GUROS Owner 920-563-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001533-15) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |