Organization
CESA #11 RURAL HEALTH DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HAUGERUD (CLINIC DIRECTOR)
(715) 986-2020
Entity
Organization
Contact information
Practice address
225 OSTERMANN DR, TURTLE LAKE, WI 54889-9191
(715) 986-2020
Mailing address
225 OSTERMANN DR, TURTLE LAKE, WI 54889-9191
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6752-016
WI
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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