Provider Demographics
NPI:1720055015
Name:DENTAL HEALTH CENTER, S.C.
Entity Type:Organization
Organization Name:DENTAL HEALTH CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-344-7911
Mailing Address - Street 1:5541 US HIGHWAY 10 E
Mailing Address - Street 2:SUITE A
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-9117
Mailing Address - Country:US
Mailing Address - Phone:715-344-7911
Mailing Address - Fax:715-344-7912
Practice Address - Street 1:5541 US HIGHWAY 10 E
Practice Address - Street 2:SUITE A
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-9117
Practice Address - Country:US
Practice Address - Phone:715-344-7911
Practice Address - Fax:715-344-7912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty