Desiree Michele Mork, DDS
Individual provider Active NPI General Practice Dentistry · Cochrane, WI
NPI 1508083528 · NPPES record last updated Dec 29, 2011
Key facts
- NPI
- 1508083528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5882-015 (WI)
- Practice address
- 241 N. Main Street
Cochrane, WI 54622 - Phone
- (608) 248-2442
- Fax
- (608) 248-3132
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 5882-015 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mork Dental, SC | General Practice | Past | Accepting new patients |
| Roland W Pardun DDS SC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5882-015 | WI | Yes |
Addresses
Primary practice location
241 N. Main Street
Cochrane, WI 54622
Mailing address
P.O. Box 118
241 N. Main Street
Cochrane, WI 54622
Phone (608) 248-2442
Other providers in Cochrane, WI
- Kimberlee Kirste
- Jessica Kathleen Mattson
- Mork Dental, SC
- Roland W Pardun
- Jamie Lee Pronschinske
- Roland W Pardun DDS SC
- Scenic Valley Emergency Medical Services Incorporated
- Shelby Lynn Spence
All providers in Cochrane, 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 Dec 29, 2011. 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.