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Oral Surgery, Dental Specialists

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DANIEL G ELLENZ DDS

Endodontics

La Crosse, Wisconsin

Provider NPI: 1356346407

Provider Information:
 DANIEL G ELLENZ DDS
Gender: M
Not Sole Proprietor

Practice Location:
1836 SOUTH AVE  LA CROSSE, WI 54601 US
Tel: 608-782-7300  Fax: --

Business Mailing Address:
1836 SOUTH AVE  LA CROSSE, WI 54601 US
Tel: 608-782-7300  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223E0200XDental Providers
Dentist
Endodontics
WI3285
N1223E0200XDental Providers
Dentist
MNS65

Other Provider Identifiers:

IssuerNumberStateType
33479800WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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