| Family Dentistry Of West Salem, Inc. | |
|
210 N Leonard St West Salem WI 54669-1623 | |
| (608) 786-1632 | |
| (608) 786-0225 |
| Full Name | Family Dentistry Of West Salem, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 210 N Leonard St, West Salem, Wisconsin |
| Authorized Official Name and Position | Craig James Forsberg (PRESIDENT) |
| Authorized Official Contact | 6087861632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dentistry Of West Salem, Inc. 210 N Leonard St West Salem WI 54669-1623 Ph: (608) 786-1632 | Family Dentistry Of West Salem, Inc. 210 N Leonard St West Salem WI 54669-1623 Ph: (608) 786-1632 |
| NPI Number | 1821131210 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 08/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821131210 | NPI | - | NPPES |
| 33441300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2948 (Wisconsin) | Primary |
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