Cedar Lake Dental Professionals Ltd in West Bend - Prosthodontics
Cedar Lake Dental Professionals Ltd - NPI 1790840734
Cedar Lake Dental Professionals Ltd is a Prosthodontics in West Bend, Wisconsin. Cedar Lake Dental Professionals Ltd practices all healthcare services and medical treatments related to Prosthodontics. The NPI Number for Cedar Lake Dental Professionals Ltd is 1790840734. The last update date is 2020-08-22.
Cedar Lake Dental Professionals Ltd's current location address is 145 N 18th Avenue, West Bend, Wisconsin. You can contact this provider via phone number 2623343084 and fax number 2623343552. The mailing address for Cedar Lake Dental Professionals Ltd is 145 N 18th Avenue, West Bend, Wisconsin. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Cedar Lake Dental Professionals Ltd |
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Address | 145 N 18th Avenue, West Bend, Wisconsin |
Phone Number | 2623343084 |
Fax Number | 2623343552 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | OWNER |
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Authorized Official Name | Brueggeman L Lysette |
Credentials | DDS |
Telephone Number | 2623343084 |
NPI Number Detail
NPI Number | 1790840734 |
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Provider Enumeration Date | 2006-12-27 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 145 N 18th Avenue |
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City | West Bend |
State | Wisconsin (WI) |
Post Code | 53095 |
Phone Number | 2623343084 |
Fax Number | 2623343552 |
Provider's Primary Taxonomy Detail
Speciality | Prosthodontics |
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Taxonomy | 1223P0700X |
Licence No | 4408 |
Definition: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
33761800 | WI | MEDICAID | |
33713000 | WI | -- | |
650286 | UNITED CONCORDIA |
Post Comment/ Review Below
What is the unique identification code assigned to Cedar Lake Dental Professionals Ltd by the Centers for Medicare & Medicaid Services?
The Cedar Lake Dental Professionals Ltd has been issued the NPI (National Provider Identifier) 1790840734. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Cedar Lake Dental Professionals Ltd is geographically located?
The Cedar Lake Dental Professionals Ltd is physically situated at the following location: 145 N 18Th Avenue, West Bend, WI, 53095.
What is Cedar Lake Dental Professionals Ltd's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Cedar Lake Dental Professionals Ltd is Prosthodontics, and the taxonomy code that categorizes this field of expertise is 1223P0700X.
On what date was the 1790840734 assigned to Cedar Lake Dental Professionals Ltd?
The Cedar Lake Dental Professionals Ltd was issued its 1790840734 on 2006-12-27, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Cedar Lake Dental Professionals Ltd's information last updated?
The Cedar Lake Dental Professionals Ltd's information was last updated on 2020-08-22.