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Contact Information

FIRST CITY DENTAL OF ABBOTSFORD, SC
202 BIRCH ST
ABBOTSFORD, WI54405-9439
 Phone: 715-223-4844
 Fax: 715-223-6957
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for FIRST CITY DENTAL OF ABBOTSFORD, SC

NPI Number 1053432955
LBN Legal business name FIRST CITY DENTAL OF ABBOTSFORD, SC
Authorized official TROY RENS - (OWNER)
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/02/2007
Last updated 07/09/2007 - About 12 years ago
Identifiers
WI License # WI4940
WI License # WI4941
WI Medicaid 33742700
WI Medicaid 33742800
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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