Organization
SODERBERG EYE CARE CENTER
Active
Other names
Dennis R. Soderberg O.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS RAYMOND SODERBERG O.D. (PRESIDENT)
(715) 265-7127
Entity
Organization
Contact information
Practice address
124 OAK STREET, GLENWOOD CITY, WI 54013
(715) 265-7127
(715) 265-4238
Mailing address
PO BOX 97, GLENWOOD CITY, WI 54013-0097
(715) 265-7127
(715) 265-4238
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1396
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38501900
—
WI
01
—
92533SO
BCBS
MN
Enumeration date
09/07/2006
Last updated
03/04/2009
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