Mark Robert Vande Walle is a Green Bay, Wisconsin based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Mark Robert Vande Walle is 003209 for Dentistry in Wisconsin. His current practice location is 1711 Shawano Ave, Green Bay. Patients can reach him at 920-494-9541.
Mark Robert Vande Walle is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Mark Robert Vande Walle speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Mark Robert Vande Walle
Specialization:
Dentist
Gender:
Male
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
1711 Shawano Ave, Green Bay, Wisconsin, 54303
Phone:
920-494-9541
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1083749774
NPI Enumeration Date:
22 Feb, 2007
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark Robert Vande Walle are as mentioned below.
License Number
Specialization
State
Status
003209
Dentistry
Wisconsin
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Mark Robert Vande Walle such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
33456900
Medicaid
Wisconsin
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1711 Shawano Ave, Green Bay, Wisconsin
Zip:
54303
Phone Number:
920-494-9541
Patients can reach Mark Robert Vande Walle at 1711 Shawano Ave, Green Bay, Wisconsin or can call to book an appointment on 920-494-9541. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.