| Iola Dental Clinic Sc | |
|
100 Pine Crest Lane Iola WI 54945 | |
| (715) 445-2435 | |
| (715) 445-2554 |
| Full Name | Iola Dental Clinic Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Pine Crest Lane, Iola, Wisconsin |
| Authorized Official Name and Position | James S Mays (PRESIDENT) |
| Authorized Official Contact | 7154452435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iola Dental Clinic Sc Po Box 274 Iola WI 54945 Ph: (715) 445-2435 | Iola Dental Clinic Sc 100 Pine Crest Lane Iola WI 54945 Ph: (715) 445-2435 |
| NPI Number | 1689792079 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689792079 | NPI | - | NPPES |
| 34410900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2527 (Wisconsin) | Primary |
Iola Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Pine Crest Ln, Iola, WI 54945 Phone: 715-445-2435 |