Organization
FAMILY DENTISTRY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE D LINDQUIST DDS (DENTIST)
(715) 749-3724
Entity
Organization
Contact information
Practice address
205 S DIVISION ST, ROBERTS, WI 54023
(715) 749-3724
(715) 246-6649
Mailing address
PO BOX 118, 205 S DIVISION ST, ROBERTS, WI 54023
(715) 749-3724
(715) 246-6649
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38371000
—
WI
Enumeration date
04/29/2008
Last updated
04/29/2008
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