The Grove Family Dental And Tmj Clinic, Llc is a medicare enrolled dental clinic (Dentist) in Evansville, Wisconsin. The current practice location for The Grove Family Dental And Tmj Clinic, Llc is 109 S Madison St, Evansville, Wisconsin. For appointments, you can reach them via phone at
(608) 882-4441. The mailing address for The Grove Family Dental And Tmj Clinic, Llc is 109 S Madison St, Evansville, Wisconsin and phone number is (608) 882-4441.
The Grove Family Dental And Tmj Clinic, Llc is licensed to practice in Wisconsin (license number 4078). The clinic also participates in the medicare program and its
NPI number is 1295933430. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(608) 882-4441.
Dental Care Clinic Profile
| Full Name | The Grove Family Dental And Tmj Clinic, Llc |
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| Speciality | Dentist |
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| Location | 109 S Madison St, Evansville, Wisconsin |
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| Authorized Official Name and Position | John Charles Gernetzke (MEMBER) |
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| Authorized Official Contact | 6088824441 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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The Grove Family Dental And Tmj Clinic, Llc
109 S Madison St
Evansville
WI 53536-1319
Ph: (608) 882-4441 | The Grove Family Dental And Tmj Clinic, Llc
109 S Madison St
Evansville
WI 53536-1319
Ph: (608) 882-4441 |
NPI Details:
| NPI Number | 1295933430 |
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| Provider Enumeration Date | 07/10/2007 |
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| Last Update Date | 07/10/2007 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 5395830186 |
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| Medicare Enrollment ID | O20071009000677 |
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Medical Identifiers
Medical identifiers for The Grove Family Dental And Tmj Clinic, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295933430 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 4078 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
The Grove Family Dental And Tmj Clinic, Llc acts as a billing entity for following providers:
| Provider Name | John C Gernetzke |
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| Provider Type | Practitioner - Oral Surgery |
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| Provider Identifiers | NPI Number: 1629050026
PECOS PAC ID: 2163517566
Enrollment ID: I20071001000188 |
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