Organization
WESTERN WISCONSIN ORAL HEALTH INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA L JERUE RDH (PROGRAM HEAD)
(608) 785-9843
Entity
Organization
Contact information
Practice address
1300 BADGER ST, HEALTH SCIENCE CENTER, LA CROSSE, WI 54601-1502
(608) 789-6101
Mailing address
304 6TH ST N, LA CROSSE, WI 54601-3342
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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