| Peter Frandsen Pediatric Dentistry, Llc | |
|
2 Copeland Ave Ste 203 La Crosse WI 54603-3419 | |
| (608) 782-4054 | |
| (608) 782-2198 |
| Full Name | Peter Frandsen Pediatric Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2 Copeland Ave Ste 203, La Crosse, Wisconsin |
| Authorized Official Name and Position | Jennifer Haydon (OFFICE MANAGER) |
| Authorized Official Contact | 6087824054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Frandsen Pediatric Dentistry, Llc 2 Copeland Ave Ste 203 La Crosse WI 54603-3419 Ph: (608) 782-4054 | Peter Frandsen Pediatric Dentistry, Llc 2 Copeland Ave Ste 203 La Crosse WI 54603-3419 Ph: (608) 782-4054 |
| NPI Number | 1316586779 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 01/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316586779 | NPI | - | NPPES |
| 100094671 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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