ADVANCED DENTAL CARE CLINIC SC; NPI #1396258752

Contact Information

ADVANCED DENTAL CARE CLINIC SC

62 S PLEASANT VIEW ROAD
PLYMOUTH, WI 53073

Phone: 920-892-8466
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for ADVANCED DENTAL CARE CLINIC SC

NPI #	`1396258752`
LBN Legal business name	ADVANCED DENTAL CARE CLINIC SC
Authorized official	HOOMAN SERESHKI - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	11/08/2017
Last updated	12/13/2019 - About 6 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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