OrganizationActive
Modern Dental Center LLC
NPI 1689320897 · Dentist · Fond Du Lac, WI
Provider details
- NPI number
- 1689320897
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Michael Cole, Vp Insurance Plan Management(727) 424-2990
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
101 Camelot Dr Ste 3
Fond Du Lac, WI 54935-8048
Phone: (920) 921-1244
Street-level locationGet directions
Mailing address
101 Camelot Dr Ste 3
Fond Du Lac, WI 54935-8048
Other names (DBA / former)
- Other name
- Dental Care Alliance
Registry dates
- Enumerated
- 2022-02-25
- Last updated
- 2022-02-25
- Certified
- 2022-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.