Dental Haven For Children Sc

LBN: Dental Haven For Children Sc
Dental Haven For Children Sc is an health care organization with primary practice located at 2612 E Calumet St , Appleton WI 54915-4104. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Dental Haven For Children Sc can be contacted via phone (920) 739-6808, or through Hernandez, Gonzalo E via phone (920) 739-6808.

Contact Information

Primary practice address
2612 E Calumet St Appleton WI 54915-4104
Phone: (920) 739-6808
Fax: (888) 492-5007
Website:
Map and Directions
Authorized official contact:
Name: Hernandez, Gonzalo E Doctor of Dental Surgery (DDS)
Phone: (920) 739-6808

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 4564-015 Wisconsin

Profile Details

NPI number 1598105637
LBN Legal business name Dental Haven For Children Sc
DBA Doing business as
Authorized official Hernandez, Gonzalo E Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 3rd, 2013
Last updated Mar 7th, 2023 - about 2 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 1598105637 NPPES
Wisconsin MEDICAID 33718600

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