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WISCONSIN DENTAL GROUP S.C. NPI 1497403927


NPI Information

NPI: 1497403927
Provider Name: WISCONSIN DENTAL GROUP, S.C.

Doing Business As: FORWARDDENTAL GREEN BAY DEVELOPMENT DRIVE

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2593 DEVELOPMENT DR STE 280
GREEN BAY, WI
ZIP 54311
Phone: (262) 646-8333
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WISCONSIN DENTAL GROUP, S.C. is a general practice dentist in Green Bay, WI. The provider is 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. WISCONSIN DENTAL GROUP, S.C. NPI is 1497403927. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Forwarddental Green Bay Development Drive.

The provider's business location address is:

2593 DEVELOPMENT DR STE 280
GREEN BAY, WI
ZIP 54311-999
Phone: (262) 646-8333
Fax: (262) 646-2410

The provider's authorized official is Celia Hayes .
The authorized official title is Credentialing Coordinator and has the following contact phone number (217) 540-2100.

The enumeration date for this NPI number is 3/14/2022 and was last updated on 4/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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