| Douglas D Podoll Dds Sc | |
|
1460 10th Ave Baldwin WI 54002 | |
| (715) 684-5858 | |
| (715) 684-5968 |
| Full Name | Douglas D Podoll Dds Sc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1460 10th Ave, Baldwin, Wisconsin |
| Authorized Official Name and Position | Douglas D Podoll (PRESIDENT) |
| Authorized Official Contact | 7156845858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas D Podoll Dds Sc 1460 10th Ave Po Box 516 Baldwin WI 54002 Ph: (715) 684-5858 | Douglas D Podoll Dds Sc 1460 10th Ave Baldwin WI 54002 Ph: (715) 684-5858 |
| NPI Number | 1063563674 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063563674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3237 (Wisconsin) | Primary |
Kristo Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1460 10th Ave, Baldwin, WI 54002 Phone: 715-684-5858 | |
Purdy Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1730 8th Avenue, Baldwin, WI 54002 Phone: 715-688-3110 |