Provider Demographics
NPI:1457934945
Name:LIESEN PINZL KESSINGER DENTAL LLC
Entity Type:Organization
Organization Name:LIESEN PINZL KESSINGER DENTAL LLC
Other - Org Name:DR.S LIESEN AND PINZL, DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-762-4825
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-0260
Mailing Address - Country:US
Mailing Address - Phone:715-356-3474
Mailing Address - Fax:715-358-5145
Practice Address - Street 1:240 OAK ST
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty