NPI | 1295427342 |
---|---|
Doing Business As | CHIPPEWA FALLS DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | KYMBERLI DARRACOTT Credentialing Specialist 262-654-5555 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-05-25 |
Last Update Date | 2023-07-13 |