| Bad River Dental Office | |
|
53585 Nokomis Rd Ashland WI 54806-4272 | |
| (715) 682-7133 | |
| (715) 685-7857 |
| Full Name | Bad River Dental Office |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 53585 Nokomis Rd, Ashland, Wisconsin |
| Authorized Official Name and Position | Debra Ann Tutor (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 7156827133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bad River Dental Office 53585 Nokomis Rd Ashland WI 54806-4272 Ph: (715) 682-7133 | Bad River Dental Office 53585 Nokomis Rd Ashland WI 54806-4272 Ph: (715) 682-7133 |
| NPI Number | 1255682183 |
|---|---|
| Provider Enumeration Date | 10/02/2012 |
| Last Update Date | 10/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255682183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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