| Leipnitz Dental Clinic, Sc | |
|
2521 Broadway St S Menomonie WI 54751-3914 | |
| (715) 235-7371 | |
| (715) 235-7380 |
| Full Name | Leipnitz Dental Clinic, Sc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2521 Broadway St S, Menomonie, Wisconsin |
| Authorized Official Name and Position | Todd Aleron Leipnitz (PRESIDENT/OWNER) |
| Authorized Official Contact | 7152357371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leipnitz Dental Clinic, Sc 2521 Broadway St S Menomonie WI 54751-3914 Ph: (715) 235-7371 | Leipnitz Dental Clinic, Sc 2521 Broadway St S Menomonie WI 54751-3914 Ph: (715) 235-7371 |
| NPI Number | 1295922946 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 09/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295922946 | NPI | - | NPPES |
| 33757000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5165-015 (Wisconsin) | Primary |
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