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2201 Humes Road Suite 150 Janesville WI 53545 | |
| (608) 302-6408 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2201 Humes Road Suite 150, Janesville, Wisconsin |
| Authorized Official Name and Position | Lindsay Bearden (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2201 Humes Road Suite 150 Janesville WI 53545 Ph: (608) 302-6408 | 2201 Humes Road Suite 150 Janesville WI 53545 Ph: (608) 302-6408 |
| NPI Number | 1679998314 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679998314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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