Provider Demographics
NPI:1053864207
Name:ULBRICH, LAUREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:ULBRICH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7827 COUNTY ROAD F
Mailing Address - Street 2:
Mailing Address - City:BIRCHWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54817-9530
Mailing Address - Country:US
Mailing Address - Phone:507-319-3369
Mailing Address - Fax:
Practice Address - Street 1:5 WEST AVE
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-1385
Practice Address - Country:US
Practice Address - Phone:715-736-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-24
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8759122300000X
WI6001109-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist