Cedar Lake Dental Professionals Ltd is a Dental Clinic in West Bend, Wisconsin. It is located at 145 N 18th Avenue, West Bend, WI and its contact number is 262-334-3084. The authorized person for Cedar Lake Dental Professionals Ltd is Dr. Lysette L Brueggeman
who is Owner of the clinic and their contact number is 262-334-3084. The primary license number for Cedar Lake Dental Professionals Ltd is 4408 (Prosthodontics) in Wisconsin. Cedar Lake Dental Professionals Ltd Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Cedar Lake Dental Professionals Ltd Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Cedar Lake Dental Professionals Ltd
Specialization:
General Practice Dentistry
Clinic Address:
145 N 18th Avenue, West Bend, Wisconsin, 53095
Phone:
262-334-3084
Fax:
262-334-3552
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Lysette L Brueggeman
Position:
Owner
Contact Number:
262-334-3084
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Cedar Lake Dental Professionals Ltd clinic are as mentioned below.
NPI Number:
1790840734
NPI Enumeration Date:
27 Dec, 2006
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Cedar Lake Dental Professionals Ltd are as mentioned below.
Specialization
License Number
State
Status
Prosthodontics
4408
Wisconsin
Primary
General Practice
4368
Wisconsin
Secondary
Prosthodontics
4408
Wisconsin
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
33761800
Other
Wisconsin
Medicaid
33713000
Medicaid
Wisconsin
650286
Other
United Concordia
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Cedar Lake Dental Professionals Ltd 145 N 18th Avenue, West Bend, Wisconsin
Zip:
53095
Phone Number:
262-334-3084
Fax Number:
262-334-3552
Patients can reach Cedar Lake Dental Professionals Ltd at 145 N 18th Avenue, West Bend, Wisconsin or can call to book an appointment on 262-334-3084. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.