FOX RIVER DENTAL ASSOCIATES SC (NPI# 1629124375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629124375 |
| Entity Type | Organization |
| Organization Name | FOX RIVER DENTAL ASSOCIATES SC |
| Practice Address |
120 Commercial St Berlin WI 54923-1737 |
| Mailing Address |
Po Box 45 Berlin WI 54923-0045 |
| Practice Telephone | 9203613080 |
| Practice Fax Number | 9203613083 |
| Mailing Telephone | 9203613080 |
| Mailing Fax Number | 9203613083 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2008-03-10 |
| Authorized Official Name | SHARON MATTICE (OFFICE MANAGER) |
| Authorized Official Telephone | 9203613080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5000722015 | WI | Dental Providers |
| Street Address |
120 COMMERCIAL ST |
| City | BERLIN |
| State | WI |
| Zip Code | 54923-1737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144375924 | Christopher Roger Lau | Chiropractor | 120 Commercial St, Berlin, WI 54923-1737 | 2007-01-24 |
| 1487896858 | Lau Chiropractic and Wellness Center, LLC | Chiropractor | 120 Commercial St, Berlin, WI 54923-1737 | 2009-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910067 | Mary Ellen F Pumper | Pharmacist | 861 County Rd F, Berlin, WI 54923 | 2020-10-21 |
| 1962020792 | Brown Wilcox Trustees, Inc. | Home Health | 347 East Huron Street, Berlin, WI 54923 | 2020-07-08 |
| 1083050942 | Veterinary Clinic Berlin/ripon | Veterinarian | W1915 Cty Road F, Berlin, WI 54923 | 2013-05-20 |
| 1114078243 | David Earl Johanknecht | Optometrist | 269 Memorial Dr, Suite 103, Berlin, WI 54923 | 2007-01-16 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| 1942280821 | Dina N Nelson | Nurse Anesthetist, Certified Registered | 225 Memorial Drive, Anesthesia Dept, Berlin, WI 54923 | 2006-01-18 |
| 1679574453 | Craig Batley | Family Medicine | W832 Hwy 91, Suite 3, Berlin, WI 54923 | 2005-08-03 |
| 1477043313 | Lina D Ramos | Registered Nurse | 225 Memorial Dr, Berlin, WI 54923 | 2018-05-16 |
| 1760887392 | Waushara Dental Associate Sc | Dentist | 322 Broadway, Berlin, WI 54923 | 2014-10-24 |
| Find all providers in zip 54923 | ||||
| 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 |
|---|---|---|---|---|
| 1942511563 | Corey Lee Smith | Dentist | 11204 Racetrack Rd Ste 102, Berlin, MD 21811 | 2010-06-29 |
| 1215152921 | Michael John Depalma Sr. | Dentist | 500 Franklin Avenue, Unit 3, Berlin, MD 21811 | 2007-04-16 |
| 1861510653 | Gerard Frederick Ott | Dentist | 1 Pitts St, Berlin, MD 21811-1127 | 2007-03-27 |
| 1487791141 | David Harry Schiff | Dentist | 11200 Racetrack Rd Ste A103, Berlin, MD 21811-3809 | 2007-01-31 |
| 1275689119 | Dennis Karl Pezzolesi Jr. | Dentist | 39 Webster Square Rd, Berlin, CT 06037-2326 | 2007-01-25 |
| 1417037276 | Steven Michael Hall | Dentist | 9928 Old Ocean City Blvd, Suite 12, Berlin, MD 21811-1122 | 2006-10-16 |
| 1992890230 | Ajay Soni | Dentist | 68 S White Horse Pike, Berlin, NJ 08009-2324 | 2006-10-03 |
| 1790884443 | Richard Joseph Gawarzewski | Dentist | 3 Harker Avenue, Suite E, Berlin, NJ 08009-2300 | 2006-09-21 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1184731986 | Kevin C Yoder | Dentist | 4913 West Main St., Berlin, OH 44610 | 2006-08-25 |
| Find all providers in BERLIN | ||||
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| 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.