Provider Demographics
NPI:1609021237
Name:DR. VERONICA TOVAR D.D.S,, S.C.
Entity Type:Organization
Organization Name:DR. VERONICA TOVAR D.D.S,, S.C.
Other - Org Name:FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-757-9440
Mailing Address - Street 1:W6179 NEUBERT RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7988
Mailing Address - Country:US
Mailing Address - Phone:920-757-9440
Mailing Address - Fax:920-757-9390
Practice Address - Street 1:W6179 NEUBERT RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7988
Practice Address - Country:US
Practice Address - Phone:920-757-9440
Practice Address - Fax:920-757-9390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5365-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1750448171OtherPERSONAL NPI