| The Missing Tooth Solution | |
|
3000 Riley Rd Suite A Sparta WI 54656-6588 | |
| (608) 269-0607 | |
| (608) 269-0608 |
| Full Name | The Missing Tooth Solution |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3000 Riley Rd, Sparta, Wisconsin |
| Authorized Official Name and Position | Leo J. Malin (OWNER) |
| Authorized Official Contact | 6082690607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Missing Tooth Solution 3000 Riley Rd Suite A Sparta WI 54656-6588 Ph: (608) 269-0607 | The Missing Tooth Solution 3000 Riley Rd Suite A Sparta WI 54656-6588 Ph: (608) 269-0607 |
| NPI Number | 1861643017 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861643017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4262 (Wisconsin) | Primary |
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