John A Satterwhite, D.D.S

Individual provider Active NPI General Practice Dentistry · Phillips, WI

NPI 1043329253 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1043329253
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5001357 (WI)
Practice address
605 Peterson Dr
Phillips, WI 54555-1430
Phone
(715) 339-3021
Fax
(715) 339-3022
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5001357WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northwoods Dentistry, S.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001357 WI Yes

Addresses

Primary practice location

605 Peterson Dr
Phillips, WI 54555-1430

Mailing address

605 Peterson Dr
PO Box 10
Phillips, WI 54555-1430
Phone (715) 339-3021

Other identifiers

IdentifierTypeStateIssuer
33614700MedicaidWI

Other providers in Phillips, WI

All providers in Phillips, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.