| Dr. Brian J. Underwood, D.d.s., S.c. | |
|
105 5th Ave N Strum WI 54770-9252 | |
| (715) 695-2918 | |
| (715) 695-3852 |
| Full Name | Dr. Brian J. Underwood, D.d.s., S.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 105 5th Ave N, Strum, Wisconsin |
| Authorized Official Name and Position | Brian James Underwood (OWNER) |
| Authorized Official Contact | 7156952918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Brian J. Underwood, D.d.s., S.c. 105 5th Ave N Po Box 400 Strum WI 54770-9252 Ph: (715) 695-2918 | Dr. Brian J. Underwood, D.d.s., S.c. 105 5th Ave N Strum WI 54770-9252 Ph: (715) 695-2918 |
| NPI Number | 1437329901 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437329901 | NPI | - | NPPES |
| 33693400 | Medicaid | WI | |
| 391675083011 | Other | BLUE CROSS BLUE SHIELD | |
| 391675083001 | Other | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3750 (Wisconsin) | Primary |