Christian, Russell Laroy
Christian, Russell Laroy is an sole proprietor health care provider with primary practice located at 522 Springdale St Ste 101 , Mount Horeb WI 53572-1780. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Christian, Russell Laroy can be contacted via phone (608) 437-5564.Contact Information
Primary practice address
522 Springdale St Ste 101
Mount Horeb WI 53572-1780
Phone: (608) 437-5564
Fax: (608) 437-8790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4703-015 | Wisconsin |
Profile Details
| NPI number | 1336149525 |
|---|---|
| LBN Legal business name | Christian, Russell Laroy |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Dec 21st, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336149525 | NPPES |
| Wisconsin | Other | 1336149525 | NPI |
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