Provider Demographics
NPI:1326105230
Name:DENIS C. SCHARINE, DDS S.C.
Entity Type:Organization
Organization Name:DENIS C. SCHARINE, DDS S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:SCHARINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-446-2213
Mailing Address - Street 1:403 WOLF RIVER DR
Mailing Address - Street 2:P.O. BOX 500
Mailing Address - City:FREMONT
Mailing Address - State:WI
Mailing Address - Zip Code:54940-9038
Mailing Address - Country:US
Mailing Address - Phone:920-446-2213
Mailing Address - Fax:920-446-2215
Practice Address - Street 1:403 WOLF RIVER DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:WI
Practice Address - Zip Code:54940-9038
Practice Address - Country:US
Practice Address - Phone:920-446-2213
Practice Address - Fax:920-446-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33442600Medicaid