La Crosse Pediatric Dentistry Llc | |
2 Copeland Ave Ste 203 La Crosse WI 54603-3419 | |
(608) 782-4054 | |
(608) 782-2198 |
Full Name | La Crosse Pediatric Dentistry Llc |
---|---|
Speciality | Clinic/center |
Location | 2 Copeland Ave Ste 203, La Crosse, Wisconsin |
Authorized Official Name and Position | Jonathan M Hanks (ONWER/DDS) |
Authorized Official Contact | 6087824054 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
La Crosse Pediatric Dentistry Llc 2 Copeland Ave Ste 203 La Crosse WI 54603-3419 Ph: (608) 782-4054 | La Crosse Pediatric Dentistry Llc 2 Copeland Ave Ste 203 La Crosse WI 54603-3419 Ph: (608) 782-4054 |
NPI Number | 1831550813 |
---|---|
Provider Enumeration Date | 03/17/2016 |
Last Update Date | 03/17/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831550813 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1001174-15 (Wisconsin) | Primary |
News Archive
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› Verified 4 days ago
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