Organization
DENTAL ASSOCIATES OF LAKE MILLS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M. SCHLEICHER (OFFICE ADMINISTRATOR)
(920) 648-2331
Entity
Organization
Contact information
Practice address
311 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9681
(920) 648-2331
(920) 648-3437
Mailing address
311 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9681
(920) 648-2331
(920) 648-3437
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3647
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33489300
—
WI
05
—
33794300
—
WI
Enumeration date
08/07/2008
Last updated
08/07/2008
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