| Woodland Dental Grp., Sc | |
|
W232s7590 Woodland Ln Big Bend WI 53103-9651 | |
| (262) 662-3066 | |
| (262) 662-2070 |
| Full Name | Woodland Dental Grp., Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | W232s7590 Woodland Ln, Big Bend, Wisconsin |
| Authorized Official Name and Position | Nichols Lawrence Nelson (PRESIDENT) |
| Authorized Official Contact | 2626623066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodland Dental Grp., Sc W232s7590 Woodland Ln Big Bend WI 53103-9651 Ph: (262) 662-3066 | Woodland Dental Grp., Sc W232s7590 Woodland Ln Big Bend WI 53103-9651 Ph: (262) 662-3066 |
| NPI Number | 1144241340 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144241340 | NPI | - | NPPES |
| 79300 | Other | WI | WPS# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3326 (Wisconsin) | Primary |