NPI | 1962532309 |
---|---|
Doing Business As | FORWARDDENTAL GREEN BAY |
Entity Type | Organization |
Authorized Contact | CELIA HAYES Credentialing COO Rdinator 217-540-2100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Enumeration Date | 2007-03-06 |
Last Update Date | 2022-03-14 |