| Mosinee Family Dental Llc | |
|
435 Orbiting Dr Ste A Mosinee WI 54455-1762 | |
| (715) 693-4530 | |
| Not Available |
| Full Name | Mosinee Family Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 435 Orbiting Dr Ste A, Mosinee, Wisconsin |
| Authorized Official Name and Position | Leah Bouton (OFFICE MANAGER) |
| Authorized Official Contact | 7156934530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosinee Family Dental Llc 435 Orbiting Dr Ste A Mosinee WI 54455-1762 Ph: (715) 693-4530 | Mosinee Family Dental Llc 435 Orbiting Dr Ste A Mosinee WI 54455-1762 Ph: (715) 693-4530 |
| NPI Number | 1982143574 |
|---|---|
| Provider Enumeration Date | 02/16/2017 |
| Last Update Date | 02/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982143574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5542-15 (Wisconsin) | Primary |
| 122300000X | Dentist | 5001639-15 (Wisconsin) | Secondary |
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