| Wisconsin Dental Group, S.c. | |
|
2572 Ironwood Dr Ste 108 Sun Prairie WI 53590-8845 | |
| (414) 481-7400 | |
| (414) 481-0173 |
| Full Name | Wisconsin Dental Group, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2572 Ironwood Dr Ste 108, Sun Prairie, Wisconsin |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Dental Group, S.c. 2572 Ironwood Dr Ste 108 Sun Prairie WI 53590-8845 Ph: (414) 481-7400 | Wisconsin Dental Group, S.c. 2572 Ironwood Dr Ste 108 Sun Prairie WI 53590-8845 Ph: (414) 481-7400 |
| NPI Number | 1073261533 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 03/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073261533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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