Organization
LAKES DENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C. MARTINEAU D.D.S. (PRESIDENT)
(715) 546-2101
Entity
Organization
Contact information
Practice address
1858 SUPERIOR ST., THREE LAKES, WI 54562-0410
(715) 546-2101
(715) 546-4331
Mailing address
PO BOX 410, THREE LAKES, WI 54562-0410
(715) 546-2101
(715) 546-4331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5002065
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33373200
—
WI
Enumeration date
07/24/2006
Last updated
08/22/2020
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