Provider Demographics
NPI:1083787626
Name:ADLER, DENNIS G (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:G
Last Name:ADLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572-2032
Mailing Address - Country:US
Mailing Address - Phone:608-437-5519
Mailing Address - Fax:608-437-6521
Practice Address - Street 1:303 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-2032
Practice Address - Country:US
Practice Address - Phone:608-437-5519
Practice Address - Fax:608-437-6521
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50020280151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice