Provider Demographics
NPI:1023184348
Name:SALONEK, BETH A (DDS)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:SALONEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W PRAIRIE VIEW RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3639
Mailing Address - Country:US
Mailing Address - Phone:715-720-9125
Mailing Address - Fax:715-720-1475
Practice Address - Street 1:235 W PRAIRIE VIEW RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3639
Practice Address - Country:US
Practice Address - Phone:715-720-9125
Practice Address - Fax:715-720-1475
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice