Mary K Danner
Individual provider Active NPI Dental Hygienist · Bowler, WI
NPI 1740438688 · NPPES record last updated Sep 4, 2008
Key facts
- NPI
- 1740438688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 5509-016 (WI)
- Practice address
- W12802 County Road a
Bowler, WI 54416-9551 - Phone
- (715) 793-4144
- NPI assigned
- Sep 4, 2008
- 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 |
|---|---|---|---|
| 5509-016 | WI | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 5509-016 | WI | Yes |
Addresses
Primary practice location
W12802 County Road a
Bowler, WI 54416-9551
Mailing address
W12802 County Road a
Bowler, WI 54416-9551
Phone (715) 793-4144
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33829500 | Medicaid | WI |
Other providers in Bowler, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2008. 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.