| La Petite Dentistry | |
|
131 Carmichael Rd Ste 200 Hudson WI 54016-8271 | |
| (855) 527-3848 | |
| (855) 457-3329 |
| Full Name | La Petite Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 131 Carmichael Rd Ste 200, Hudson, Wisconsin |
| Authorized Official Name and Position | Andy Mancini (OWNER/PRESIDENT) |
| Authorized Official Contact | 8555273848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Petite Dentistry 131 Carmichael Rd Ste 200 Hudson WI 54016-8271 Ph: (855) 527-3848 | La Petite Dentistry 131 Carmichael Rd Ste 200 Hudson WI 54016-8271 Ph: (855) 527-3848 |
| NPI Number | 1467747303 |
|---|---|
| Provider Enumeration Date | 06/17/2011 |
| Last Update Date | 06/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467747303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 6499-015 (Wisconsin) | Primary |
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