Provider Demographics
NPI:1851514103
Name:DENTAL ARTS S.C.
Entity Type:Organization
Organization Name:DENTAL ARTS S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:DOROFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-268-7177
Mailing Address - Street 1:404 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1058
Mailing Address - Country:US
Mailing Address - Phone:715-268-7177
Mailing Address - Fax:715-268-5716
Practice Address - Street 1:404 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1058
Practice Address - Country:US
Practice Address - Phone:715-268-7177
Practice Address - Fax:715-268-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4545-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty