Individual
ROBERT DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 258-1160
(715) 256-3079
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18804
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000669010
MEDICARE PTAN
WI
05
—
31006400
—
WI
Enumeration date
08/03/2006
Last updated
11/23/2011
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