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Port Dental Group Sc
Customized Equipment (DME) in Port Washington, Wisconsin
NPI 1801913173

Port Dental Group Sc is a Customized Equipment (DME) based in Port Washington, WI and is specialized in Customized Equipment. Port Dental Group Sc practices in Port Washington, WI. The NPI Number for Port Dental Group Sc is 1801913173 and holds a License No. 4635 (Wisconsin).

The current practice location address for Port Dental Group Sc is 1000 N Wisconsin St, Port Washington, WI and can be reached out via phone at 262-284-9767 and via fax at 262-284-5228.

Location: 1000 N Wisconsin St, Port Washington, WI, 53074-1285
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1801913173
Provider Name
Port Dental Group Sc
Credential
Provider Entity Type
Organization
Address
1000 N Wisconsin St, Port Washington, WI, 53074-1285
Phone Number
262-284-9767
Fax Number
262-284-5228
Provider Enumeration Date
03/23/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33723100 05 WI
institution
Provider Business Practice Location Address Details
Address
1000 N Wisconsin St
City
Port Washington
State
Wisconsin
Zip
53074-1285
Phone Number
262-284-9767
Fax Number
262-284-5228
person
Provider Business Mailing Address Details
Address
1000 N Wisconsin St
City
Port Washington
State
Wisconsin
Zip
53074-1285
Phone Number
262-284-9767
Fax Number
262-284-5228
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
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Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
4635 (Wisconsin)
Definition
Definition to come...
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