Gary L Kaefer DDS SC

Organization Active NPI General Practice Dentistry · Grantsburg, WI

NPI 1508949082 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1508949082
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
5001913 (WI)
Legal business name
GARY L KAEFER DDS SC
Practice address
302 South Pine St
Grantsburg, WI 54840
Phone
(715) 463-2882
Fax
(715) 463-2885
NPI assigned
Oct 20, 2006
Organization subpart
No

Authorized official

Name
Dr. Gary L Kaefer, DDS
Title
Owner
Phone
(715) 463-2882

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Gary Kaefer Family Dentisty DDS SC (2 organizations share this tax ID)

Locations

302 S Pine St
Grantsburg, WI 54840
Phone (715) 463-2882

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 5001913 WI Yes

Addresses

Primary practice location

302 South Pine St
Grantsburg, WI 54840

Mailing address

302 South Pine St
Grantsburg, WI 54840
Phone (715) 463-2882

Other providers in Grantsburg, WI

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

Sources for this page

Verify at the official NPI Registry.