| Direct Denture Service | |
|
3000 Riley Rd Sparta WI 54656-6726 | |
| (608) 518-2859 | |
| (608) 269-6315 |
| Full Name | Direct Denture Service |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3000 Riley Rd, Sparta, Wisconsin |
| Authorized Official Name and Position | Stephen Johnston (DENTIST) |
| Authorized Official Contact | 6085182859 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct Denture Service 3000 Riley Rd Sparta WI 54656-6726 Ph: (608) 518-2859 | Direct Denture Service 3000 Riley Rd Sparta WI 54656-6726 Ph: (608) 518-2859 |
| NPI Number | 1649607730 |
|---|---|
| Provider Enumeration Date | 10/03/2013 |
| Last Update Date | 10/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649607730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5752 (Minnesota) | Primary |
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