| Dr. Mark Boeche D.d.s. Inc. | |
|
1915 E Milwaukee St Janesville WI 53545-2647 | |
| (608) 754-5768 | |
| (608) 754-7195 |
| Full Name | Dr. Mark Boeche D.d.s. Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1915 E Milwaukee St, Janesville, Wisconsin |
| Authorized Official Name and Position | Mark R. Boeche (OWNER/ PRESIDENT) |
| Authorized Official Contact | 6087545768 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Mark Boeche D.d.s. Inc. 1915 E Milwaukee St Janesville WI 53545-2647 Ph: (608) 754-5768 | Dr. Mark Boeche D.d.s. Inc. 1915 E Milwaukee St Janesville WI 53545-2647 Ph: (608) 754-5768 |
| NPI Number | 1235140013 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235140013 | NPI | - | NPPES |
| 33471100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3112 (Wisconsin) | Primary |
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