Terryl Bauer

Individual provider Active NPI Dental Hygienist · Eleva, WI

NPI 1194126730 · NPPES record last updated Sep 15, 2014

Key facts

NPI
1194126730
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
6665-16 (WI)
Practice address
W47 County Road Z
Eleva, WI 54738-9577
Phone
(715) 946-3226
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
Yes

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
6665-16WIMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 6665-16 WI Yes

Addresses

Primary practice location

W47 County Road Z
Eleva, WI 54738-9577

Mailing address

W47 County Road Z
Eleva, WI 54738-9577
Phone (715) 946-3226

Other providers in Eleva, WI

All providers in Eleva, WI · Dental Hygienist in Wisconsin

Sources for this page

Verify at the official NPI Registry.