Daniel A Mullenbach, DDS
Individual provider Active NPI General Practice Dentistry · Lacrosse, WI
NPI 1184767352 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184767352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2798 (WI)
- Practice address
- 201 S 7TH St
Lacrosse, WI 54601 - Phone
- (608) 782-6616
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2798 | WI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2798 | WI | Yes |
Addresses
Primary practice location
201 S 7TH St
Lacrosse, WI 54601
Mailing address
201 S 7TH St
Lacrosse, WI 54601
Phone (608) 782-6616
Other providers in Lacrosse, WI
- Benjamin Markworth
- Sharon R Martin
- Erin McFarlane
- Michelle Patricia McHenry
- Randall David Moseng
- Doreen M Olson
- Cynthia Lee Patterson-Rhorer
- Susan S Quinn
- Heather S Rabe
- Red Feather Therapy and Consulting, LLC
All providers in Lacrosse, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.