Organization
ST. CROIX DENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA MORTEL (CREDENTIALING COORDINATOR)
(715) 483-0429
Entity
Organization
Contact information
Practice address
26425 LAKELAND AVE S, WEBSTER, WI 54893-8343
(715) 866-4420
(715) 866-4368
Mailing address
235 E STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3261
(715) 483-0507
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/15/2019
Last updated
11/12/2019
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