| Lac Du Flambeau Band Of Lake Superior Chippewa Indians | |
|
128 Old Abe Rd Lac Du Flambeau WI 54538-9682 | |
| (715) 588-4466 | |
| (715) 588-2269 |
| Full Name | Lac Du Flambeau Band Of Lake Superior Chippewa Indians |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 128 Old Abe Rd, Lac Du Flambeau, Wisconsin |
| Authorized Official Name and Position | Jeanne M Wolfe (COMPLIANCE OFFICER) |
| Authorized Official Contact | 7155884466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Du Flambeau Band Of Lake Superior Chippewa Indians 128 Old Abe Road Lac Du Flambeau WI 54538-9682 Ph: (715) 588-4466 | Lac Du Flambeau Band Of Lake Superior Chippewa Indians 128 Old Abe Rd Lac Du Flambeau WI 54538-9682 Ph: (715) 588-4466 |
| NPI Number | 1427347426 |
|---|---|
| Provider Enumeration Date | 03/31/2011 |
| Last Update Date | 01/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427347426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Lac Du Flambeau Band Of Lake Superior Chippewa Indians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3378 N. Schilleman Rd, Lac Du Flambeau, WI 54538 Phone: 715-388-0762 Fax: 715-588-1889 |