Beaver Dam Dental Llc | |
302 N Spring St Beaver Dam WI 53916-2044 | |
(920) 887-8421 | |
(920) 887-8431 |
Full Name | Beaver Dam Dental Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 302 N Spring St, Beaver Dam, Wisconsin |
Authorized Official Name and Position | Genevieve E Poppe (PARTNER) |
Authorized Official Contact | 6083583370 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Beaver Dam Dental Llc Po Box 436 Beaver Dam WI 53916-0436 Ph: (920) 887-8421 | Beaver Dam Dental Llc 302 N Spring St Beaver Dam WI 53916-2044 Ph: (920) 887-8421 |
NPI Number | 1699985051 |
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Provider Enumeration Date | 05/23/2007 |
Last Update Date | 01/31/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699985051 | NPI | - | NPPES |
33555900 | Medicaid | WI | |
1871881169 | Medicaid | WI | |
33477900 | Medicaid | WI |
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› Verified 4 days ago
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