Douglas D Podoll Dds Dc | |
404 Wisconsin Ave Amery WI 54001 | |
(715) 268-8109 | |
(715) 268-4620 |
Full Name | Douglas D Podoll Dds Dc |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 404 Wisconsin Ave, Amery, Wisconsin |
Authorized Official Name and Position | Douglas D Podoll (PRESIDENT) |
Authorized Official Contact | 7152688109 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Douglas D Podoll Dds Dc 404 Wisconsin Ave Amery WI 54001 Ph: (715) 268-8109 | Douglas D Podoll Dds Dc 404 Wisconsin Ave Amery WI 54001 Ph: (715) 268-8109 |
NPI Number | 1568566057 |
---|---|
Provider Enumeration Date | 09/12/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568566057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3237 (Wisconsin) | Primary |
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Kristo Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Wisconsin Ave, Amery, WI 54001 Phone: 715-268-8109 | |
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