| Gillett Dental Care, S.c. | |
|
137 E Main St Gillett WI 54124-9386 | |
| (920) 855-6091 | |
| Not Available |
| Full Name | Gillett Dental Care, S.c. |
|---|---|
| Speciality | Dentist |
| Location | 137 E Main St, Gillett, Wisconsin |
| Authorized Official Name and Position | Evelyn Katrina Hauser-frederick (PRESIDENT) |
| Authorized Official Contact | 9208552155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gillett Dental Care, S.c. 137 E Main St P.o. Box 266 Gillett WI 54124-9386 Ph: (920) 855-6091 | Gillett Dental Care, S.c. 137 E Main St Gillett WI 54124-9386 Ph: (920) 855-6091 |
| NPI Number | 1356554851 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 06/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356554851 | NPI | - | NPPES |
| 5002024-015 | Other | WI | STATE DENTAL LICENSE |
| 33374500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5002024-015 (Wisconsin) | Primary |