National Provider Identifier Database

ADVANCED DENTAL CARE CLINIC SC
Dental


Contact Information

ADVANCED DENTAL CARE CLINIC SC
62 S PLEASANT VIEW ROAD
PLYMOUTH, WI53073
Phone: 920-892-8466
Fax:
Website:
Specialty Taxonomy Code
* Dental 261QD0000X

* Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL CARE CLINIC SC

NPI Number 1396258752
Legal business name
LBN
ADVANCED DENTAL CARE CLINIC SC
Authorized official HOOMAN SERESHKI - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/08/2017
Last updated 12/13/2019 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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