| Algoma Lakeview Dental Care, S.c. | |
|
1223 Lake St Algoma WI 54201-1447 | |
| (920) 487-5648 | |
| (920) 487-5658 |
| Full Name | Algoma Lakeview Dental Care, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1223 Lake St, Algoma, Wisconsin |
| Authorized Official Name and Position | Rebecca H Prust (PRESIDENT) |
| Authorized Official Contact | 9204875648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Algoma Lakeview Dental Care, S.c. 1223 Lake St Po Box 275 Algoma WI 54201-0275 Ph: (920) 487-5648 | Algoma Lakeview Dental Care, S.c. 1223 Lake St Algoma WI 54201-1447 Ph: (920) 487-5648 |
| NPI Number | 1700130648 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 10/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700130648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Algoma Fama Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1421 Lake St, Algoma, WI 54201 Phone: 920-487-2733 |