| Mauston Dental Center | |
|
3125 Main St Stevens Point WI 54481-3269 | |
| (920) 787-5514 | |
| (920) 787-4737 |
| Full Name | Mauston Dental Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3125 Main St, Stevens Point, Wisconsin |
| Authorized Official Name and Position | Erin Lamore (ENROLLMENT AND CREDENTIALING SPEC.) |
| Authorized Official Contact | 9207879459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mauston Dental Center Po Box 1440 Wautoma WI 54982-1440 Ph: (920) 787-5514 | Mauston Dental Center 3125 Main St Stevens Point WI 54481-3269 Ph: (920) 787-5514 |
| NPI Number | 1790786929 |
|---|---|
| Provider Enumeration Date | 08/10/2005 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 8729996574 |
|---|---|
| Medicare Enrollment ID | O20030331000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790786929 | NPI | - | NPPES |
| 100076513 | Medicaid | WI | |
| 100080272 | Medicaid | WI | |
| 32955200 | Medicaid | WI | |
| 100076692 | Medicaid | WI |
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