Central Wisconsin Endodontic Specialists LLC
Dentist, Endodontics in Wausau, WI. Organization (NPI-2).
NPI number1164031464
StatusActive
Last updated in NPPESMay 27, 2021
Details
- NPI
- 1164031464
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Wisconsin Endodontic Specialists LLC
- Organization subpart
- No
- Enumeration date
- Jul 23, 2020
- Certification date
- May 27, 2021
- Last updated
- May 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | – | – | Yes |
Other names
- Mpc Endodontics (Doing Business As)
Practice location
2606 Stewart Avenue#102
Wausau, WI 54401
Phone 715-848-3982
Mailing address
2606 Stewart Avenue#102
Wausau, WI 54401
Authorized official
Mitch Weiland
Senior Accountant
6083430818
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