| Wsl Dental Management Llc | |
|
114 4th St Tipton IN 46072-1851 | |
| (765) 675-2432 | |
| Not Available |
| Full Name | Wsl Dental Management Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 4th St, Tipton, Indiana |
| Authorized Official Name and Position | Walter Samuel Langkau (OWNER) |
| Authorized Official Contact | 7154822323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wsl Dental Management Llc 3843 Idlewind Dr Westfield IN 46074-6315 Ph: (715) 482-2323 | Wsl Dental Management Llc 114 4th St Tipton IN 46072-1851 Ph: (765) 675-2432 |
| NPI Number | 1932796885 |
|---|---|
| Provider Enumeration Date | 12/27/2020 |
| Last Update Date | 12/27/2020 |
| Medicare PECOS PAC ID | 5799190708 |
|---|---|
| Medicare Enrollment ID | O20210224000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932796885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Walter Samuel Langkau |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023440948 PECOS PAC ID: 6608281613 Enrollment ID: I20210224000813 |
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