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Contact Information

MCBRIDE DENTAL SC
336 HARBOR VIEW DR
FOND DU LAC, WI54935
 Phone: 920-922-9400
 Fax: 920-921-3260
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MCBRIDE DENTAL SC

NPI Number 1073624326
LBN Legal business name MCBRIDE DENTAL SC
Authorized official TIMOTHY MCBRIDE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
WI Medicaid 33490200
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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