Organization
ENDODONTIC SPECIALISTS OF LACROSSE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK B NORDEEN DDS (PRESIDENT OF CORPORATION)
(608) 783-3636
Entity
Organization
Contact information
Practice address
2700 NATIONAL DR, STE 102, ONALASKA, WI 54650
(608) 783-3636
(608) 783-3639
Mailing address
2700 NATIONAL DR, STE 102, ONALASKA, WI 54650
(608) 783-3636
(608) 783-3639
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
WI
Other
Enumeration date
08/02/2005
Last updated
07/21/2022
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