Ebben & Pynenberg DDS SC
Organization Active NPI Dentist · Little Chute, WI
NPI 1164550208 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164550208
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 2739 (WI)
- Legal business name
- EBBEN & PYNENBERG DDS SC
- Practice address
- 607 Wilson St
Little Chute, WI 54140 - Phone
- (920) 788-3542
- Fax
- (920) 788-6741
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael Charles Ebben, DDS
- Title
- President
- Phone
- (920) 788-3542
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 2739 | WI | Yes |
| Dentist |
122300000X | 4142 | WI |
Addresses
Primary practice location
607 Wilson St
Little Chute, WI 54140
Mailing address
607 Wilson St
Little Chute, WI 54140
Phone (920) 788-3542
Other providers in Little Chute, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.