| Park Avenue Dental | |
|
777 E Park Ave Chippewa Falls WI 54729-3508 | |
| (715) 723-0366 | |
| (715) 723-4635 |
| Full Name | Park Avenue Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 777 E Park Ave, Chippewa Falls, Wisconsin |
| Authorized Official Name and Position | Patrick Michael Snyder (PRESIDENT) |
| Authorized Official Contact | 7157230366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Avenue Dental 777 E Park Ave Chippewa Falls WI 54729-3508 Ph: (715) 723-0366 | Park Avenue Dental 777 E Park Ave Chippewa Falls WI 54729-3508 Ph: (715) 723-0366 |
| NPI Number | 1144239724 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144239724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001705 (Wisconsin) | Primary |
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