| Fall Creek Dental | |
|
122 State St Fall Creek WI 54742 | |
| (715) 877-2113 | |
| (715) 877-3495 |
| Full Name | Fall Creek Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 122 State St, Fall Creek, Wisconsin |
| Authorized Official Name and Position | Tony L Pilgrim (DENTIST) |
| Authorized Official Contact | 7158772113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fall Creek Dental 122 State St Box 66 Fall Creek WI 54742 Ph: (715) 877-2113 | Fall Creek Dental 122 State St Fall Creek WI 54742 Ph: (715) 877-2113 |
| NPI Number | 1295955342 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295955342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3104 (Wisconsin) | Primary |
Fall Creek Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 S State St, Fall Creek, WI 54742 Phone: 715-877-2113 |