Soderberg, Dennis Raymond

Soderberg, Dennis Raymond is an sole proprietor health care provider with primary practice located at 1620 10Th Ave , Baldwin WI 54002-9033. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Soderberg, Dennis Raymond can be contacted via phone (715) 684-3310.

Contact Information

Primary practice address
1620 10Th Ave Baldwin WI 54002-9033
Phone: (715) 684-3310
Fax: (715) 684-4560
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1396 Wisconsin
Eye and Vision Services Providers / Optometrist 152W00000X 1549 Minnesota

Profile Details

NPI number 1649235524
LBN Legal business name Soderberg, Dennis Raymond
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2006
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649235524 NPPES
Wisconsin Other 391170106044 CLAIMS MANAGEMENT
Wisconsin Other 391170106036 CLAIMS MANAGEMENT
Wisconsin Other 22-12358 CLAIMS MANAGEMENT
Wisconsin MEDICAID 38411800 CLAIMS MANAGEMENT
Wisconsin Other 391170106028 CLAIMS MANAGEMENT
Wisconsin Other 774002 CLAIMS MANAGEMENT
Wisconsin Other 795000 CLAIMS MANAGEMENT
Wisconsin Other 92530S0 CLAIMS MANAGEMENT

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