Organization
GLACIER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WYN STECKBAUER D.M.D. (DENTIST)
(920) 235-3251
Entity
Organization
Contact information
Practice address
1840 EVANS ST, OSHKOSH, WI 54901-2362
(920) 235-3251
(920) 235-3567
Mailing address
1840 EVANS STREET, OSHKOSH, WI 54902-2362
(920) 235-3251
(920) 235-3567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5396
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841391109
INDIVIDUAL NPI
WI
Enumeration date
04/23/2007
Last updated
08/22/2020
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