| Grandview Dental S.c. | |
|
900 Crestview Dr Suite 240 Hudson WI 54016-9517 | |
| (715) 381-5556 | |
| (715) 381-5355 |
| Full Name | Grandview Dental S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 900 Crestview Dr, Hudson, Wisconsin |
| Authorized Official Name and Position | Patrick Lee Wolfe (PRESIDENT AND DENTIST) |
| Authorized Official Contact | 7153815556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grandview Dental S.c. 900 Crestview Drive Suite 240 Hudson WI 54016-9517 Ph: (715) 381-5556 | Grandview Dental S.c. 900 Crestview Dr Suite 240 Hudson WI 54016-9517 Ph: (715) 381-5556 |
| NPI Number | 1639202013 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639202013 | NPI | - | NPPES |
| 33723000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4584 (Wisconsin) | Primary |
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