Western Wisconsin Oral Health Initiative | |
1300 Badger St Health Science Center La Crosse WI 54601-1502 | |
(608) 789-6101 | |
Not Available |
Full Name | Western Wisconsin Oral Health Initiative |
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Speciality | Clinic/center - Dental |
Location | 1300 Badger St, La Crosse, Wisconsin |
Authorized Official Name and Position | Barbara L Jerue (PROGRAM HEAD) |
Authorized Official Contact | 6087859843 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Western Wisconsin Oral Health Initiative 304 6th St N La Crosse WI 54601-3342 Ph: () - | Western Wisconsin Oral Health Initiative 1300 Badger St Health Science Center La Crosse WI 54601-1502 Ph: (608) 789-6101 |
NPI Number | 1265605265 |
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Provider Enumeration Date | 04/10/2008 |
Last Update Date | 04/10/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265605265 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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