Provider Demographics
NPI:1407355308
Name:APPLETON DENTAL GROUP LLC
Entity Type:Organization
Organization Name:APPLETON DENTAL GROUP LLC
Other - Org Name:DAWN PAFFEL, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:PAFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-734-1803
Mailing Address - Street 1:335 E WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4821
Mailing Address - Country:US
Mailing Address - Phone:920-734-1803
Mailing Address - Fax:
Practice Address - Street 1:335 E WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4821
Practice Address - Country:US
Practice Address - Phone:920-734-1803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty