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DE PERE FAMILY DENTISTRY LLC NPI 1225307267


NPI Information

NPI: 1225307267
Provider Name: DE PERE FAMILY DENTISTRY LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1001 N BROADWAY
DE PERE, WI
ZIP 54115
Phone: (920) 336-2500
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DE PERE FAMILY DENTISTRY LLC is a general practice dentist in De Pere, 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. DE PERE FAMILY DENTISTRY LLC NPI is 1225307267. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1001 N BROADWAY
DE PERE, WI
ZIP 54115-609
Phone: (920) 336-2500
Fax: (920) 336-4684

The provider's authorized official is Cyril Joseph Van Sistine .
The authorized official title is Partner / Manager and has the following contact phone number (920) 336-2500.

The enumeration date for this NPI number is 12/20/2011 and was last updated on 12/20/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice5001499WISCONSINYes

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: 5/5/2024

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