Organization
FIRST IMPRESSIONS OF MEDFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM SEEHAFER (ACCOUNTANT)
(715) 842-4649
Entity
Organization
Contact information
Practice address
124 S MAIN ST, MEDFORD, WI 54451-1841
(715) 748-5435
Mailing address
PO BOX 48, SCHOFIELD, WI 54476-0048
(715) 748-5435
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38388300
—
WI
Enumeration date
08/30/2011
Last updated
08/30/2011
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