Organization
FALL CREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY L PILGRIM DDS (DENTIST)
(715) 877-2113
Entity
Organization
Contact information
Practice address
122 STATE ST, FALL CREEK, WI 54742
(715) 877-2113
(715) 877-3495
Mailing address
122 STATE ST, BOX 66, FALL CREEK, WI 54742
(715) 877-2113
(715) 877-3495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3104
WI
Other
Enumeration date
04/30/2007
Last updated
08/22/2020
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