Dr Stephen Reisner Dentistry SC
Organization Active NPI Dentist · Ladysmith, WI
NPI 1811064231 · NPPES record last updated Jan 25, 2013
Key facts
- NPI
- 1811064231
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 0003677 (WI)
- Legal business name
- DR STEPHEN REISNER DENTISTRY SC
- Practice address
- 120 1St St S
Ladysmith, WI 54848-1801 - Phone
- (715) 532-5606
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephen D Reisner, DDS
- Title
- Owner
- Phone
- (715) 532-5606
Practitioners 1
-
Stephen D Reisner, DDS
National Provider Directory
Locations
120 1st St S
Ladysmith, WI 54848
Phone (715) 532-5605
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 0003677 | WI | Yes |
Addresses
Primary practice location
120 1St St S
Ladysmith, WI 54848-1801
Mailing address
120 First St So
Ladysmith, WI 54848
Phone (715) 532-5606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33489100 | Medicaid | WI |
Other providers in Ladysmith, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2013. 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.