Provider Demographics
NPI:1679698757
Name:BAUER WILLIAMS, ANGELA MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:BAUER WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:710 KATIE CT
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:WI
Mailing Address - Zip Code:53523-9308
Mailing Address - Country:US
Mailing Address - Phone:608-423-3615
Mailing Address - Fax:608-423-4275
Practice Address - Street 1:710 KATIE CT
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:WI
Practice Address - Zip Code:53523-9308
Practice Address - Country:US
Practice Address - Phone:608-423-3615
Practice Address - Fax:608-423-4275
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5402-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice