| Northwoods Dental Sleep Therapy Inc | |
|
865 N Railroad St Eagle River WI 54521-8834 | |
| (715) 479-6100 | |
| Not Available |
| Full Name | Northwoods Dental Sleep Therapy Inc |
|---|---|
| Speciality | Dentist |
| Location | 865 N Railroad St, Eagle River, Wisconsin |
| Authorized Official Name and Position | Darrin J Gremban (OWNER) |
| Authorized Official Contact | 7154796100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwoods Dental Sleep Therapy Inc 865 N Railroad St Eagle River WI 54521-8834 Ph: (715) 479-6100 | Northwoods Dental Sleep Therapy Inc 865 N Railroad St Eagle River WI 54521-8834 Ph: (715) 479-6100 |
| NPI Number | 1285974386 |
|---|---|
| Provider Enumeration Date | 02/26/2013 |
| Last Update Date | 10/13/2015 |
| Medicare PECOS PAC ID | 7315256476 |
|---|---|
| Medicare Enrollment ID | O20151013000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285974386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5242-15 (Wisconsin) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
Potrykus Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 N Railroad St, Eagle River, WI 54521 Phone: 715-479-4686 Fax: 715-479-5281 | |
Gremban & Gremban Dental S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 N Railroad St, Eagle River, WI 54521 Phone: 715-479-6100 Fax: 715-477-2162 |