West Prairie Dental LLC
Dentist, General Practice in Sun Prairie, WI. Organization (NPI-2).
NPI number1124900907
StatusActive
Last updated in NPPESAug 28, 2025
Details
- NPI
- 1124900907
- Entity type
- Organization (NPI-2)
- Legal business name
- West Prairie Dental LLC
- Organization subpart
- No
- Enumeration date
- Jul 23, 2025
- Certification date
- Aug 28, 2025
- Last updated
- Aug 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | – | – |
Practice location
2630 Ironwood DrSun Prairie, WI 53590-8830
Phone 608-837-7842 · Fax 608-318-8787
Mailing address
2630 Ironwood DrSun Prairie, WI 53590-8830
Phone 608-837-7842 · Fax 608-318-8787
Authorized official
Kelsey Laufenberg
Office Manager
6088377842
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