is a Pediatric Dental Clinic in Chippewa Falls, Wisconsin. It is located at 583 Lakeland Dr, Chippewa Falls, WI and its contact number is 715-723-2000. The authorized person for is Miss Jeanette Marie Goodlet
who is Office Manager of the clinic and their contact number is 715-723-2000. The primary license number for is 5855-015 (Pediatric Dentistry) in Wisconsin. Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Pediatric Dentistry
Clinic Address:
583 Lakeland Dr, Chippewa Falls, Wisconsin, 54729-1689
Phone:
715-723-2000
Fax:
715-723-3712
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:
Miss Jeanette Marie Goodlet
Position:
Office Manager
Contact Number:
715-723-2000
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 clinic are as mentioned below.
NPI Number:
1972863397
NPI Enumeration Date:
18 May, 2012
NPI Last Update On:
02 Dec, 2014
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
5855-015
Wisconsin
Primary
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
33796700
Medicaid
Wisconsin
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
583 Lakeland Dr, Chippewa Falls, Wisconsin
Zip:
54729-1689
Phone Number:
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Fax Number:
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Patients can reach at 583 Lakeland Dr, Chippewa Falls, Wisconsin or can call to book an appointment on 715-723-2000. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.