| Dr John C Gernetzke, DDS | |
|
109 S Madison St, Evansville, WI 53536-1319 | |
| (608) 882-4441 | |
| (608) 882-4967 |
| Full Name | Dr John C Gernetzke |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 109 S Madison St, Evansville, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629050026 | NPI | - | NPPES |
| 33688500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4078 (Wisconsin) | Primary |
| Entity Name | The Grove Family Dental And Tmj Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295933430 PECOS PAC ID: 5395830186 Enrollment ID: O20071009000677 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John C Gernetzke, DDS 109 S Madison St, Evansville, WI 53536-1319 Ph: (608) 882-4441 | Dr John C Gernetzke, DDS 109 S Madison St, Evansville, WI 53536-1319 Ph: (608) 882-4441 |
Dr. Melanie E. White, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 39 W Church St, Evansville, WI 53536 Phone: 608-882-4860 Fax: 608-882-4862 | |
Dr. Anna Fedak Botts, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 449 S 1st St, Evansville, WI 53536 Phone: 608-882-4338 Fax: 608-882-6777 | |
Raechel Jacobson, Dentist Medicare: Not Enrolled in Medicare Practice Location: 449 S 1st St, Evansville, WI 53536 Phone: 608-882-4338 | |
Cali Hensel, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 109 S Madison St, Evansville, WI 53536 Phone: 608-882-4441 | |
Dr. Margaret B Wieser, DMD Dentist Medicare: Medicare Enrolled Practice Location: 449 S 1st St, Evansville, WI 53536 Phone: 608-882-4338 |