Organization
FIRST IMPRESSIONS, SC ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HOMEYER (FINANCIAL COORDINATOR)
(715) 842-4649
Entity
Organization
Contact information
Practice address
413 N 17TH AVE, WAUSAU, WI 54401-4226
(715) 842-4649
Mailing address
PO BOX 61, SCHOFIELD, WI 54476-0061
(715) 842-4649
(715) 842-7331
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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