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Lakeshore Community Dental Clinic
Dental Clinic/Center in Cleveland, Wisconsin
NPI 1023275013

Lakeshore Community Dental Clinic is a Dental Clinic/Center based in Cleveland, WI and is specialized in Dental. Lakeshore Community Dental Clinic practices in Cleveland, WI. The NPI Number for Lakeshore Community Dental Clinic is 1023275013 and holds a License No. (Wisconsin).

The current practice location address for Lakeshore Community Dental Clinic is 1290 North Ave, Cleveland, WI and can be reached out via phone at 920-693-1386.

Location: 1290 North Ave, Cleveland, WI, 53015-1412
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023275013
Provider Name
Lakeshore Community Dental Clinic
Credential
Provider Entity Type
Organization
Address
1290 North Ave, Cleveland, WI, 53015-1412
Phone Number
920-693-1386
Fax Number
Provider Enumeration Date
05/19/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38394700 05 WI
institution
Provider Business Practice Location Address Details
Address
1290 North Ave
City
Cleveland
State
Wisconsin
Zip
53015-1412
Phone Number
920-693-1386
Fax Number
person
Provider Business Mailing Address Details
Address
1290 North Ave
City
Cleveland
State
Wisconsin
Zip
53015-1412
Phone Number
920-693-1386
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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