| Waushara Dental Associates S.c. | |
|
N2888 State Road 22 Wautoma WI 54982-5265 | |
| (920) 787-3200 | |
| (920) 787-2541 |
| Full Name | Waushara Dental Associates S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | N2888 State Road 22, Wautoma, Wisconsin |
| Authorized Official Name and Position | Robert K Bennot (PRESIDENT) |
| Authorized Official Contact | 9207873200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waushara Dental Associates S.c. Po Box 509 Wautoma WI 54982-0509 Ph: (920) 787-3200 | Waushara Dental Associates S.c. N2888 State Road 22 Wautoma WI 54982-5265 Ph: (920) 787-3200 |
| NPI Number | 1649382946 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649382946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
La Clinica De Los Campesinos, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-5514 Fax: 920-787-4737 |