Northern Door Dental Sc

LBN: Northern Door Dental Sc
Northern Door Dental Sc is an health care organization with primary practice located at 10589 S Highland Rd Ste 4 , Sister Bay WI 54234. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Northern Door Dental Sc can be contacted via phone (920) 854-5200, or through Mayhew, Thomas Malcolm via phone (920) 854-5200.

Contact Information

Primary practice address
10589 S Highland Rd Ste 4 Sister Bay WI 54234
Phone: (920) 854-5200
Fax: (920) 854-7601
Website:
Map and Directions
Authorized official contact:
Name: Mayhew, Thomas Malcolm Doctor of Dental Surgery (DDS)
Phone: (920) 854-5200

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5002020015 Wisconsin

Profile Details

NPI number 1013038207
LBN Legal business name Northern Door Dental Sc
DBA Doing business as
Authorized official Mayhew, Thomas Malcolm Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Jul 30th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013038207 NPPES
Wisconsin MEDICAID 33368800

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