William J. Twohig, D.D.S.

Individual provider Active NPI General Practice Dentistry · Weyauwega, WI

NPI 1275536161 · NPPES record last updated Jun 19, 2019

Key facts

NPI
1275536161
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5001630 (WI)
Practice address
417 E Ann St
Weyauwega, WI 54983-8532
Phone
(920) 867-3101
Fax
(920) 867-3108
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5001630WIMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001630 WI Yes

Addresses

Primary practice location

417 E Ann St
Weyauwega, WI 54983-8532

Mailing address

PO Box 579
Weyauwega, WI 54983-0579
Phone (920) 867-3101

Other identifiers

IdentifierTypeStateIssuer
33562400MedicaidWI
898039OtherWIUNITED CONCORDIA PROVIDER

Other providers in Weyauwega, WI

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

Sources for this page

Verify at the official NPI Registry.