| Orthodontic Specialists, Sc | |
|
1210 Draper St Baraboo WI 53913-1230 | |
| (608) 356-2151 | |
| (608) 356-2450 |
| Full Name | Orthodontic Specialists, Sc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1210 Draper St, Baraboo, Wisconsin |
| Authorized Official Name and Position | Timothy James Mcreath (PRESIDENT) |
| Authorized Official Contact | 6083562151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthodontic Specialists, Sc 1210 Draper St P.o. Box 21 Baraboo WI 53913-1230 Ph: (608) 356-2151 | Orthodontic Specialists, Sc 1210 Draper St Baraboo WI 53913-1230 Ph: (608) 356-2151 |
| NPI Number | 1588798912 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588798912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 4280015 (Wisconsin) | Primary |
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