DR. CHARLES CLAYTON LOBERG (NPI# 1245364694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245364694 |
| Entity Type | Individual |
| Full Name | DR. CHARLES CLAYTON LOBERG |
| Credential | D.D.S. |
| Practice Address |
201 Wisconsin Street New London WI 54961-1171 |
| Mailing Address |
201 Wisconsin Street New London WI 54961 |
| Practice Telephone | 9209825181 |
| Practice Fax Number | 9209821098 |
| Mailing Telephone | 9309825181 |
| Mailing Fax Number | 9209821098 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5000793-015 | WI | Dental Providers |
| Street Address |
201 WISCONSIN STREET |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-1171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1194910489 | Laurie Mollenhauer | Physical Therapist | 1405 Mill St, New London, WI 54961 | 2007-09-10 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548502438 | Elliot Harold Kimmel | Dentist | 27 Broad St, New London, CT 06320-5973 | 2013-03-19 |
| 1851569768 | Gregory P. Gutgsell Dds & Darren M Phipps Dds, Prof Assn | Dentist | 125 Newport Road, New London, NH 03257 | 2008-02-13 |
| 1134248651 | Drs. Matyas & Matyas | Dentist | 4 Shaws Cv Ste 202, New London, CT 06320-4956 | 2007-03-28 |
| 1922130160 | Charles C. Loberg D.d.s.,s.c. | Dentist | 201 Wisconsin St, New London, WI 54961-1171 | 2007-03-12 |
| 1134272511 | Paul Hanna D.m.d., P.C. | Dentist | 461 Ocean Ave, New London, CT 06320-4502 | 2007-01-19 |
| 1669530135 | Mary Wicenski | Dentist | 27 Newport Road, New London, NH 03257-1017 | 2006-12-05 |
| 1891871273 | John Allen | Dentist | 464 Montauk Ave, New London, CT 06320-4606 | 2006-10-28 |
| 1255438768 | John Leonard Difederico | Dentist | 195 Vauxhall St, New London, CT 06320 | 2006-09-19 |
| 1780799189 | Mark Christ Pothitakis | Dentist | 107 E Toothache Dr, New London, IA 52645-1141 | 2006-08-19 |
| 1255977823 | Kayla Y Perez-ortiz | Dentist | 5 Shaws Cv, New London, CT 06320-4974 | 2019-11-19 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 54961 |
Please comment or provide details below to improve the information on DR. CHARLES CLAYTON LOBERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.