| Menomonie Street Dental | |
|
1020 Menomonie St Eau Claire WI 54703-5952 | |
| (715) 834-8161 | |
| (715) 834-6272 |
| Full Name | Menomonie Street Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1020 Menomonie St, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Maria Ann Hanke (INSURANCE COORDINATOR) |
| Authorized Official Contact | 7158348161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Menomonie Street Dental 1020 Menomonie St Eau Claire WI 54703-5952 Ph: (715) 834-8161 | Menomonie Street Dental 1020 Menomonie St Eau Claire WI 54703-5952 Ph: (715) 834-8161 |
| NPI Number | 1689746851 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689746851 | NPI | - | NPPES |
| 38355800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Wisconsin) | Primary |
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