Kregenow, John R
Kregenow, John R is an individual health care provider with primary practice located at 1810 N 2Nd St , Wausau WI 54403. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Kregenow, John R can be contacted via phone (715) 848-4884.Contact Information
Primary practice address
1810 N 2Nd St
Wausau WI 54403
Phone: (715) 848-4884
Fax: (715) 845-5385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 5002132-015 | Wisconsin |
Profile Details
| NPI number | 1740205137 |
|---|---|
| LBN Legal business name | Kregenow, John R |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1740205137 | NPPES |
| Wisconsin | MEDICAID | 33375000 |
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