Provider Demographics
NPI:1972710523
Name:BAHLMAN, CINDY JANET (DDS)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:JANET
Last Name:BAHLMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 HORIZON DR STE 103C
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1250
Mailing Address - Country:US
Mailing Address - Phone:608-845-7350
Mailing Address - Fax:
Practice Address - Street 1:161 HORIZON DR STE 103C
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1250
Practice Address - Country:US
Practice Address - Phone:608-845-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice