Organization
DOUGLAS D PODOLL DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS D PODOLL DDS (PRESIDENT)
(715) 684-5858
Entity
Organization
Contact information
Practice address
1460 10TH AVE, BALDWIN, WI 54002
(715) 684-5858
(715) 684-5968
Mailing address
1460 10TH AVE, PO BOX 516, BALDWIN, WI 54002
(715) 684-5858
(715) 684-5968
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3237
WI
Other
Enumeration date
01/12/2007
Last updated
08/22/2020
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