# FIRST IMPRESSIONS SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205804663
- **Authorized official:** DR. CARL J HASH DDS (OWNER)
- **Authorized official phone:** (715) 842-4649

## Contact information

- **Practice address:** 413 N 17TH AVE, WAUSAU, WI 54401-2910
- **Practice address phone:** (715) 842-4649
- **Practice address fax:** (715) 842-7331
- **Mailing address:** 413 N 17TH AVE, WAUSAU, WI 54401-2910
- **Mailing address phone:** (715) 842-4649
- **Mailing address fax:** (715) 842-7331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3444 | WI | — |
| 1223P0221X | Pediatric Dentistry | 4970 | WI | Yes |
| 1223P0221X | Pediatric Dentistry | 5001555 | WI | — |
| 1223P0221X | Pediatric Dentistry | 5059 | WI | — |

## Other

- **Enumeration date:** 03/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38388300 | — | WI |