Fennimore Dental, Llc | |
220 Lincoln Avenue Fennimore WI 53809 | |
(608) 822-3770 | |
(608) 822-7680 |
Full Name | Fennimore Dental, Llc |
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Speciality | Dentist - General Practice |
Location | 220 Lincoln Avenue, Fennimore, Wisconsin |
Authorized Official Name and Position | Zhenyu Liang (GENERAL DENTIST) |
Authorized Official Contact | 6088223770 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fennimore Dental, Llc 220 Lincoln Avenue Fennimore WI 53809 Ph: (608) 822-3770 | Fennimore Dental, Llc 220 Lincoln Avenue Fennimore WI 53809 Ph: (608) 822-3770 |
NPI Number | 1801367545 |
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Provider Enumeration Date | 12/06/2018 |
Last Update Date | 12/06/2018 |
Identifier | Type | State | Issuer |
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1801367545 | NPI | - | NPPES |
03359042 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |