| Endodontic Specialists Of Lacrosse Ltd | |
|
2700 National Dr Ste 102 Onalaska WI 54650 | |
| (608) 783-3636 | |
| (608) 783-3639 |
| Full Name | Endodontic Specialists Of Lacrosse Ltd |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2700 National Dr, Onalaska, Wisconsin |
| Authorized Official Name and Position | Derek B Nordeen (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 6087833636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Endodontic Specialists Of Lacrosse Ltd 2700 National Dr Ste 102 Onalaska WI 54650 Ph: (608) 783-3636 | Endodontic Specialists Of Lacrosse Ltd 2700 National Dr Ste 102 Onalaska WI 54650 Ph: (608) 783-3636 |
| NPI Number | 1972504843 |
|---|---|
| Provider Enumeration Date | 08/02/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972504843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (Wisconsin) | Primary |
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