GREAT BLUE DENTAL, LLC
NPI 1720534159
Clinic/Center - Dental in Marinette, WI
Active since August 26, 2016
About Great Blue Dental, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT BLUE DENTAL, LLC (NPI 1720534159) is a healthcare organization registered as a dental in Marinette, Wisconsin and active in the NPI registry since August 2016. The organization lists Wyn Steckbauer, Owner, as its authorized official.
NPPES Registry Identity
NPI1720534159
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameGREAT BLUE DENTAL, LLC
Location Address2005 MARINETTE AVEMarinette, WI 54143-3864
Mailing Address2005 Marinette AveMarinette, WI 54143-3864
Phone(715) 732-2601
Organization SubpartNo
Authorized OfficialWyn SteckbauerOwner · (920) 235-3251
Enumeration DateAugust 26, 2016
✔ NPI 1720534159 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in WI · 5396-15
2005 MARINETTE AVE, Marinette, WI 54143
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720534159, enumerated as an "organization" on August 26, 2016.
The provider is located at 2005 MARINETTE AVE MARINETTE, WI 54143 and the phone number is (715) 732-2601.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
