| Hanneman Dustrude Dental Llc | |
|
1218 Witzel Ave Oshkosh WI 54902-5659 | |
| (920) 233-6001 | |
| (920) 233-9769 |
| Full Name | Hanneman Dustrude Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1218 Witzel Ave, Oshkosh, Wisconsin |
| Authorized Official Name and Position | Michael Lloyd Hanneman (OWNER) |
| Authorized Official Contact | 9202336001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hanneman Dustrude Dental Llc 1218 Witzel Ave Oshkosh WI 54902-5659 Ph: (920) 233-6001 | Hanneman Dustrude Dental Llc 1218 Witzel Ave Oshkosh WI 54902-5659 Ph: (920) 233-6001 |
| NPI Number | 1689018848 |
|---|---|
| Provider Enumeration Date | 04/18/2013 |
| Last Update Date | 04/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689018848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2950 (Wisconsin) | Primary |
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