Organization
PETER FRANDSEN PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HAYDON (OFFICE MANAGER)
(608) 782-4054
Entity
Organization
Contact information
Practice address
2 COPELAND AVE STE 203, LA CROSSE, WI 54603-3419
(608) 782-4054
(608) 782-2198
Mailing address
2 COPELAND AVE STE 203, LA CROSSE, WI 54603-3419
(608) 782-4054
(608) 782-2198
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094671
—
WI
Enumeration date
01/03/2020
Last updated
01/03/2020
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