| Susan Stacker Dds Sc | |
|
1220 6th Street Wausau WI 54403-3550 | |
| (715) 845-7759 | |
| (715) 845-4509 |
| Full Name | Susan Stacker Dds Sc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1220 6th Street, Wausau, Wisconsin |
| Authorized Official Name and Position | Susan A Stacker (PRESIDENT) |
| Authorized Official Contact | 7158457759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Stacker Dds Sc 1220 6th Street Wausau WI 54403-3550 Ph: (715) 845-7759 | Susan Stacker Dds Sc 1220 6th Street Wausau WI 54403-3550 Ph: (715) 845-7759 |
| NPI Number | 1497819585 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497819585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 4828 (Wisconsin) | Primary |
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