Russell A Fortune Dds Sc

LBN: Russell A Fortune Dds Sc
Russell A Fortune Dds Sc is an health care organization with primary practice located at 1600 Losey Blvd South , La Crosse WI 54601-6104. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Russell A Fortune Dds Sc can be contacted via phone (608) 782-8834, or through Fortune, Russell Alan via phone (608) 782-8834.

Contact Information

Primary practice address
1600 Losey Blvd South La Crosse WI 54601-6104
Phone: (608) 782-8834
Fax: (608) 782-5223
Website:
Map and Directions
Authorized official contact:
Name: Fortune, Russell Alan Doctor of Dental Surgery (DDS)
Phone: (608) 782-8834

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2778 Wisconsin

Profile Details

NPI number 1982706743
LBN Legal business name Russell A Fortune Dds Sc
DBA Doing business as
Authorized official Fortune, Russell Alan Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 2nd, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982706743 NPPES
Wisconsin MEDICAID 33429900

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