| Wisconsin Dental Group, S.c. | |
|
N14w23833 Stone Ridge Dr Ste 100 Waukesha WI 53188-1189 | |
| (608) 478-3772 | |
| (608) 478-3776 |
| Full Name | Wisconsin Dental Group, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | N14w23833 Stone Ridge Dr Ste 100, Waukesha, Wisconsin |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Dental Group, S.c. N14w23833 Stone Ridge Dr Ste 100 Waukesha WI 53188-1189 Ph: (608) 478-3772 | Wisconsin Dental Group, S.c. N14w23833 Stone Ridge Dr Ste 100 Waukesha WI 53188-1189 Ph: (608) 478-3772 |
| NPI Number | 1538817093 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 03/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538817093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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