Organization
KAREN M. BOETTCHER, D.D.S.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN M BOETTCHER D.D.S. (PRESIDENT)
(262) 246-6806
Entity
Organization
Contact information
Practice address
N63 W23401 MAIN ST, SUSSEX, WI 53089-0229
(262) 246-6806
(262) 246-6892
Mailing address
P O BOX 229, SUSSEX, WI 53089-0229
(262) 246-6806
(262) 246-6892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4623
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1455326
UNITED CONCORDIA
—
01
—
35913
AETNA
—
Enumeration date
11/03/2006
Last updated
08/22/2020
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