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DENTAL PARK SC
NPI 1386636959
Clinic/Center - Dental in Manitowoc, WI

Active since August 18, 2005
1503 RANDOLPH CT, MANITOWOC, WI 54220(920) 682-0321(920) 682-3128 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Dental Park Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DENTAL PARK SC (NPI 1386636959) is a healthcare organization registered as a dental in Manitowoc, Wisconsin and active in the NPI registry since August 2005. The organization lists Daniel Robert Boettcher, Partner Secretary, as its authorized official.

NPPES Registry Identity

NPI1386636959
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDENTAL PARK SC
Location Address1503 RANDOLPH CTManitowoc, WI 54220-8345
Mailing Address1503 Randolph CtManitowoc, WI 54220-8345 · (920) 682-0321 · Fax (920) 682-3128
Phone(920) 682-0321
Fax(920) 682-3128
Organization SubpartNo
Authorized OfficialDaniel Robert BoettcherPartner Secretary · (920) 682-0321
Enumeration DateAugust 18, 2005
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1386636959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1503 RANDOLPH CT, Manitowoc, WI 54220
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLAIRE TROULLIER DDS
Dentist
1503 RANDOLPH CT
MANITOWOC, WI 54220
Manitowoc County (920) 860-6841
PETER MICHAEL HANSON DDS
Dentist
1503 RANDOLPH CT
MANITOWOC, WI 54220
Manitowoc County (920) 682-0321
DR. STEVEN M GRODDY DDS
Dentist
1503 RANDOLPH CT
MANITOWOC, WI 54220
Manitowoc County (920) 682-0321
MATTHEW R CULLIGAN DDS
Dentist
1503 RANDOLPH CT
MANITOWOC, WI 54220
Manitowoc County (920) 682-0321
DANIEL R BOETTCHER DDS
Dentist
1503 RANDOLPH CT
MANITOWOC, WI 54220
Manitowoc County (920) 682-0321

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dental Park Sc's NPI number?

The NPI number for Dental Park Sc is 1386636959. It was assigned to this organization in the NPPES registry on August 18, 2005.

Where is Dental Park Sc located?

Dental Park Sc is located at 1503 Randolph Ct, Manitowoc, WI 54220. The listed phone number is (920) 682-0321.

What is Dental Park Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Dental Park Sc was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.