Provider Demographics
NPI:1922173145
Name:ARROWHEAD DENTAL CENTER SC
Entity Type:Organization
Organization Name:ARROWHEAD DENTAL CENTER SC
Other - Org Name:DR C C DIKE DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-252-7777
Mailing Address - Street 1:7630 HWY 13 SOUTH
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494
Mailing Address - Country:US
Mailing Address - Phone:715-325-5555
Mailing Address - Fax:715-345-9808
Practice Address - Street 1:2906 POST RD
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-6417
Practice Address - Country:US
Practice Address - Phone:715-345-7770
Practice Address - Fax:715-345-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001601015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty