| Gl La Crosse Dental Clinic | |
|
201 3rd St N La Crosse WI 54601-3208 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Gl La Crosse Dental Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 3rd St N, La Crosse, Wisconsin |
| Authorized Official Name and Position | Kari B Adank (CCO) |
| Authorized Official Contact | 6087758025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gl La Crosse Dental Clinic 201 N 3rd St La Crosse WI 54601-3208 Ph: (608) 782-7300 | Gl La Crosse Dental Clinic 201 3rd St N La Crosse WI 54601-3208 Ph: (608) 782-7300 |
| NPI Number | 1164080099 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 08/06/2021 |
| Medicare PECOS PAC ID | 9638082779 |
|---|---|
| Medicare Enrollment ID | O20200910003127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164080099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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