PORTWASHINGTONCTD1 LLC NPI 1992396360

NPI Details

PORTWASHINGTONCTD1 LLC is a dentist in Port Washington, WI. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. PORTWASHINGTONCTD1 LLC NPI is 1992396360. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

222 N FRANKLIN ST
PORT WASHINGTON, WI
ZIP 53074-903
Phone: (262) 235-4525

The provider's authorized official is Mitchell T Weiland .
The authorized official title is Assistant Controller and has the following contact phone number (608) 343-0818.

The CLIA number assigned to this NPI record is 52D0921803 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2021 and was last updated on 1/28/2021.

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: