Lakes Dental Services, Inc. | |
1858 Superior St. Three Lakes WI 54562-0410 | |
(715) 546-2101 | |
(715) 546-4331 |
Full Name | Lakes Dental Services, Inc. |
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Speciality | Dentist - General Practice |
Location | 1858 Superior St., Three Lakes, Wisconsin |
Authorized Official Name and Position | William C. Martineau (PRESIDENT) |
Authorized Official Contact | 7155462101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lakes Dental Services, Inc. Po Box 410 Three Lakes WI 54562-0410 Ph: (715) 546-2101 | Lakes Dental Services, Inc. 1858 Superior St. Three Lakes WI 54562-0410 Ph: (715) 546-2101 |
NPI Number | 1407878978 |
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Provider Enumeration Date | 07/24/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1407878978 | NPI | - | NPPES |
33373200 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 5002065 (Wisconsin) | Primary |