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Contact Information

ADVANCED FAMILY DENTISTRY, S.C.
123 HOSPITAL DR
SUITE 201
WATERTOWN, WI53098-3331
 Phone: 920-261-0588
 Fax: 920-261-0640
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANCED FAMILY DENTISTRY, S.C.

NPI # 1861628133
LBN Legal business name ADVANCED FAMILY DENTISTRY, S.C.
Authorized official KAREN SHERRY - (FINANCIAL COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/01/2009
Last updated 01/11/2012 - About 14 years ago
Identifiers
WI Medicaid 33741400
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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