| Robert H Southworth Dds Sc | |
|
609 Jackson St Wausau WI 54403-5550 | |
| (715) 842-1935 | |
| (715) 842-0334 |
| Full Name | Robert H Southworth Dds Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 609 Jackson St, Wausau, Wisconsin |
| Authorized Official Name and Position | Robert Hurd Southworth (PRESIDENT OWNER) |
| Authorized Official Contact | 7158421935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert H Southworth Dds Sc 609 Jackson St Wausau WI 54403-5550 Ph: (715) 842-1935 | Robert H Southworth Dds Sc 609 Jackson St Wausau WI 54403-5550 Ph: (715) 842-1935 |
| NPI Number | 1841309697 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841309697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001628-015 (Wisconsin) | Primary |
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