| Prairie Ridge Dental Care | |
|
10288 77th St Suite 300 Pleasant Prairie WI 53158-1142 | |
| (262) 612-3325 | |
| Not Available |
| Full Name | Prairie Ridge Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10288 77th St, Pleasant Prairie, Wisconsin |
| Authorized Official Name and Position | Lindsay Bearden (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Ridge Dental Care 10288 77th St Suite 300 Pleasant Prairie WI 53158-1142 Ph: (262) 612-3325 | Prairie Ridge Dental Care 10288 77th St Suite 300 Pleasant Prairie WI 53158-1142 Ph: (262) 612-3325 |
| NPI Number | 1891117495 |
|---|---|
| Provider Enumeration Date | 01/16/2014 |
| Last Update Date | 01/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891117495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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