Campbell, Mary Ann

Campbell, Mary Ann is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. She recently has only one registered license in Dental Providers / Endodontics, which is considered as her primary health care specialty. Campbell, Mary Ann can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 3855 Wisconsin

Profile Details

NPI number 1972507572
LBN Legal business name Campbell, Mary Ann
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Aug 4th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972507572 NPPES
Wisconsin MEDICAID 33734200

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