Organization
DAVID E KRIGBAUM DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KRIGBAUM (OWNER)
(715) 842-8811
Entity
Organization
Contact information
Practice address
2620 STEWART AVE, SUITE 218, WAUSAU, WI 54401-4170
(715) 842-8811
(715) 848-5109
Mailing address
2620 STEWART AVE, SUITE 218, WAUSAU, WI 54401-4170
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4501
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750453049
NPI NUMBER
WI
Enumeration date
05/01/2007
Last updated
04/20/2008
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