# WISCONSIN DENTAL SLEEP MEDICINE

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

## Provider details

- **NPI number:** 1558549451
- **Authorized official:** DR. RONALD S PREHN D.D.S (PRESIDENT)
- **Authorized official phone:** (715) 845-6419

## Contact information

- **Practice address:** 413 JEFFERSON ST, WAUSAU, WI 54403-5433
- **Practice address phone:** (715) 845-6419
- **Mailing address:** 413 JEFFERSON ST, WAUSAU, WI 54403-5433
- **Mailing address phone:** (715) 845-6419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 292200000X | Dental Laboratory | 3010 | WI | Yes |

## Other

- **Enumeration date:** 02/04/2008
- **Last updated:** 02/04/2008