Renee Boone, DDS
Individual provider Active NPI Dentist · Baraboo, WI
NPI 1720184963 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720184963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5556015 (WI)
- Practice address
- S2845 White Eagle Lane
Baraboo, WI 53913 - Phone
- (608) 355-1240
- Fax
- (608) 356-6347
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 5556015 | WI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5556015 | WI | Yes |
Addresses
Primary practice location
S2845 White Eagle Lane
Baraboo, WI 53913
Mailing address
S2845 White Eagle Lane
Baraboo, WI 53913
Phone (608) 355-1240
Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.