| Ethan E. Lawler, D.d.s., S.c. | |
|
6881 South Lake Avenue Lake Nebagamon WI 54849-9264 | |
| (715) 374-2856 | |
| (715) 374-2299 |
| Full Name | Ethan E. Lawler, D.d.s., S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6881 South Lake Avenue, Lake Nebagamon, Wisconsin |
| Authorized Official Name and Position | Sueane Christine Novack (OFFICE MANAGER) |
| Authorized Official Contact | 7153742856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan E. Lawler, D.d.s., S.c. Po Box 520 Lake Nebagamon WI 54849-0520 Ph: (715) 374-2856 | Ethan E. Lawler, D.d.s., S.c. 6881 South Lake Avenue Lake Nebagamon WI 54849-9264 Ph: (715) 374-2856 |
| NPI Number | 1255976312 |
|---|---|
| Provider Enumeration Date | 11/13/2019 |
| Last Update Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255976312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Michael R Lawler Dds Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6881 S Lake Avenue, Lake Nebagamon, WI 54849 Phone: 715-374-2856 Fax: 715-374-2299 |