Organization
WESTERN DAIRYLAND EOC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES W SCHWARTZ (EXECUTIVE DIRECTOR)
(715) 985-2391
Entity
Organization
Contact information
Practice address
23122 WHITEHALL RD, INDEPENDENCE, WI 54747-7702
(715) 985-2391
(715) 985-3239
Mailing address
23122 WHITEHALL RD, INDEPENDENCE, WI 54747-7702
(715) 985-2391
(715) 985-3239
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5946016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38395400
—
WI
Enumeration date
07/10/2007
Last updated
07/10/2007
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