Organization
BEAVER DAM DENTAL LLC
Active
Parent organization
STEPPING STONE DENTAL PARTNERS
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEPPING STONE DENTAL PARTNERS
Authorized official
MRS. GENEVIEVE E POPPE (PARTNER)
(608) 358-3370
Entity
Organization
Contact information
Practice address
302 N SPRING ST, BEAVER DAM, WI 53916-2044
(920) 887-8421
(920) 887-8431
Mailing address
PO BOX 436, BEAVER DAM, WI 53916-0436
(920) 887-8421
(920) 887-8431
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1384G
WI
1223G0001X
General Practice Dentistry
Primary
3480
WI
1223G0001X
General Practice Dentistry
6749-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871881169
—
WI
05
—
33477900
—
WI
05
—
33555900
—
WI
Enumeration date
05/23/2007
Last updated
01/31/2013
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