| Acacia Lane Dental, S.c. | |
|
664 Acacia Ln Rhinelander WI 54501-2873 | |
| (715) 365-8664 | |
| (715) 365-8668 |
| Full Name | Acacia Lane Dental, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 664 Acacia Ln, Rhinelander, Wisconsin |
| Authorized Official Name and Position | Gregory Dana Edwards (PRESIDENT) |
| Authorized Official Contact | 7153658664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Acacia Lane Dental, S.c. Po Box 1165 664 Acacia Lane Rhinelander WI 54501-1165 Ph: (715) 365-8664 | Acacia Lane Dental, S.c. 664 Acacia Ln Rhinelander WI 54501-2873 Ph: (715) 365-8664 |
| NPI Number | 1609987288 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609987288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Wisconsin) | Primary |
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