| Black River Falls Dental Center | |
|
N6571 Lumberjack Guy Rd Black River Falls WI 54615-5405 | |
| (715) 670-0400 | |
| Not Available |
| Full Name | Black River Falls Dental Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | N6571 Lumberjack Guy Rd, Black River Falls, Wisconsin |
| Authorized Official Name and Position | Kymberli Darracott (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2626545555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black River Falls Dental Center 1307 N Saint Joseph Ave Marshfield WI 54449-1340 Ph: () - | Black River Falls Dental Center N6571 Lumberjack Guy Rd Black River Falls WI 54615-5405 Ph: (715) 670-0400 |
| NPI Number | 1285325811 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 07/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285325811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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