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Organization

CHIPPEWA VALLEY ENDODONTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENDRA KAY BODA DDS, MS (PRESIDENT/OWNER)
(715) 552-8165
Entity
Organization

Contact information

Practice address
3004 GOLF RD STE 102, EAU CLAIRE, WI 54701-8794
(715) 552-8165
Mailing address
3004 GOLF RD STE 102, EAU CLAIRE, WI 54701-8794
(715) 552-8165

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6901-15
WI

Other

Enumeration date
01/09/2018
Last updated
01/09/2018
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