Judythe Leigh Bauer, RDH

Individual provider Active NPI Dental Hygienist · Nekoosa, WI

NPI 1295987352 · NPPES record last updated Oct 21, 2008

Key facts

NPI
1295987352
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
2917-016 (WI)
Practice address
1160 Rome Center Dr
Nekoosa, WI 54457-8705
Phone
(715) 422-7750
Fax
(715) 424-9027
NPI assigned
Oct 21, 2008
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
2917-016WIMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2917-016 WI Yes

Addresses

Primary practice location

1160 Rome Center Dr
Nekoosa, WI 54457-8705

Mailing address

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7773

Other providers in Nekoosa, WI

All providers in Nekoosa, WI · Dental Hygienist in Wisconsin

Sources for this page

Verify at the official NPI Registry.