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Contact Information

NORTHERN DOOR DENTAL SC
10589 S HIGHLAND RD STE 4
SISTER BAY, WI54234
 Phone: 920-854-5200
 Fax: 920-854-7601
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for NORTHERN DOOR DENTAL SC · (Female)

NPI Number 1013038207
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2007
Last updated 07/30/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • WI License # 5002020015
  • WI Medicaid 33368800
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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