| Trimark Dental Clinic, Llp | |
|
2130 Kennedy Rd Janesville WI 53545-0887 | |
| (608) 752-7452 | |
| (608) 752-4918 |
| Full Name | Trimark Dental Clinic, Llp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2130 Kennedy Rd, Janesville, Wisconsin |
| Authorized Official Name and Position | Patricia Ann Lyons (DENTIST/PARTNER) |
| Authorized Official Contact | 6087527452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trimark Dental Clinic, Llp 2130 Kennedy Rd Janesville WI 53545-0887 Ph: (608) 752-7452 | Trimark Dental Clinic, Llp 2130 Kennedy Rd Janesville WI 53545-0887 Ph: (608) 752-7452 |
| NPI Number | 1366772204 |
|---|---|
| Provider Enumeration Date | 12/27/2009 |
| Last Update Date | 12/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366772204 | NPI | - | NPPES |
| 33369200 | Medicaid | WI | |
| 33788200 | Medicaid | WI | |
| 33752400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0004660 (Wisconsin) | Primary |
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