| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 705 Rivard St, Somerset, Wisconsin |
| Authorized Official Name and Position | Douglas Steven Wolff (OWNER DENTIST) |
| Authorized Official Contact | 6514392600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11240 Stillwater Blvd N Lake Elmo MN 55042 Ph: () - | 705 Rivard St Somerset WI 54025 Ph: (715) 247-3318 |
| NPI Number | 1689757080 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689757080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |