| Cornerstone Dental | |
|
1713 N Main St West Bend WI 53090-1545 | |
| (262) 334-4083 | |
| (262) 334-4996 |
| Full Name | Cornerstone Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1713 N Main St, West Bend, Wisconsin |
| Authorized Official Name and Position | Ellen Dowden (OWNER) |
| Authorized Official Contact | 4148703072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Dental 1713 N Main St West Bend WI 53090-1545 Ph: (262) 334-4083 | Cornerstone Dental 1713 N Main St West Bend WI 53090-1545 Ph: (262) 334-4083 |
| NPI Number | 1780182758 |
|---|---|
| Provider Enumeration Date | 01/24/2018 |
| Last Update Date | 01/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780182758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7242-15 (Wisconsin) | Primary |
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