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Cedar Lake Dental Professionals Ltd
Prosthodontist in West Bend, Wisconsin
NPI 1790840734

Cedar Lake Dental Professionals Ltd is a Prosthodontist based in West Bend, WI and is specialized in Prosthodontics. Cedar Lake Dental Professionals Ltd practices in West Bend, WI. The NPI Number for Cedar Lake Dental Professionals Ltd is 1790840734 and holds a License No. 4368 (Wisconsin).

The current practice location address for Cedar Lake Dental Professionals Ltd is 145 N 18Th Avenue, West Bend, WI and can be reached out via phone at 262-334-3084 and via fax at 262-334-3552.

Location: 145 N 18Th Avenue, West Bend, WI, 53095
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790840734
Provider Name
Cedar Lake Dental Professionals Ltd
Credential
Provider Entity Type
Organization
Address
145 N 18Th Avenue, West Bend, WI, 53095
Phone Number
262-334-3084
Fax Number
262-334-3552
Provider Enumeration Date
12/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33761800 01 WI MEDICAID
33713000 05 WI
650286 01 UNITED CONCORDIA
institution
Provider Business Practice Location Address Details
Address
145 N 18Th Avenue
City
West Bend
State
Wisconsin
Zip
53095
Phone Number
262-334-3084
Fax Number
262-334-3552
person
Provider Business Mailing Address Details
Address
145 N 18Th Avenue
City
West Bend
State
Wisconsin
Zip
53095
Phone Number
262-334-3084
Fax Number
262-334-3552
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
4408 (Wisconsin)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Prosthodontics
Taxonomy
1223P0700X
License No.
4368 (Wisconsin)
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
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