Delta Dental Of Wisconsin Foundation Inc | |
941 Michigan Ave Stevens Point WI 54481 | |
(715) 204-1180 | |
(715) 204-3901 |
Full Name | Delta Dental Of Wisconsin Foundation Inc |
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Speciality | Clinic/center - Dental |
Location | 941 Michigan Ave, Stevens Point, Wisconsin |
Authorized Official Name and Position | Ann Boson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7153437209 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Delta Dental Of Wisconsin Foundation Inc Po Box 828 Stevens Point WI 54481-0828 Ph: () - | Delta Dental Of Wisconsin Foundation Inc 941 Michigan Ave Stevens Point WI 54481 Ph: (715) 204-1180 |
NPI Number | 1134898786 |
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Provider Enumeration Date | 09/08/2021 |
Last Update Date | 09/08/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134898786 | NPI | - | NPPES |
5495-015 | Other | WI | STATE LICENSE |
1002597-16 | Other | WI | STATE LICENSE |
1002005-15 | Other | WI | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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