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Contact Information

ABC FAMILY DENTAL SERVICES, S.C.
613 CENTER DR
LUXEMBURG, WI54217-1031
 Phone: 920-845-2225
 Fax: 920-845-5627
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ABC FAMILY DENTAL SERVICES, S.C.

NPI Number 1871638254
LBN Legal business name ABC FAMILY DENTAL SERVICES, S.C.
Authorized official BRYAN IWEN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/21/2007
Last updated 04/15/2009 - About 17 years ago
Identifiers
WI License # 4930 AND 4892
WI Medicaid 33740400
WI Medicaid 33744300
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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