| Great River Orthodontic Specialists, Sc | |
|
1200 Main St La Crosse WI 54601-4468 | |
| (608) 782-6778 | |
| Not Available |
| Full Name | Great River Orthodontic Specialists, Sc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1200 Main St, La Crosse, Wisconsin |
| Authorized Official Name and Position | Brenda Sawyer (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7158355182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great River Orthodontic Specialists, Sc 3902 Oakwood Hills Pkwy Eau Claire WI 54701-7780 Ph: (715) 835-5182 | Great River Orthodontic Specialists, Sc 1200 Main St La Crosse WI 54601-4468 Ph: (608) 782-6778 |
| NPI Number | 1124573902 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 08/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124573902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 1001026 (Wisconsin) | Primary |
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