| Western Dairyland Eoc | |
|
23140 Whitehall Rd Independence WI 54747-7702 | |
| (715) 985-2391 | |
| (715) 985-2581 |
| Full Name | Western Dairyland Eoc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 23140 Whitehall Rd, Independence, Wisconsin |
| Authorized Official Name and Position | James W Schwartz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7159852391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Dairyland Eoc Po Box 125 Independence WI 54747-0125 Ph: () - | Western Dairyland Eoc 23140 Whitehall Rd Independence WI 54747-7702 Ph: (715) 985-2391 |
| NPI Number | 1255660759 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 12/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255660759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Baxa Dental Inc., S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 35791 Osseo Rd, Independence, WI 54747 Phone: 715-985-3316 Fax: 715-985-2542 |