Breneman-Wisong, Lynn M

Breneman-Wisong, Lynn M is an individual health care provider with primary practice located at 125 Scott St , Davenport IA 52801-1130. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Breneman-Wisong, Lynn M can be contacted via phone (563) 336-3221.

Contact Information

Primary practice address
125 Scott St Davenport IA 52801-1130
Phone: (563) 336-3221
Fax: (563) 336-3229
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 08399 Iowa

Profile Details

NPI number 1497815948
LBN Legal business name Breneman-Wisong, Lynn M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Apr 29th, 2013 - about 13 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 1497815948 NPPES
Iowa Other 08399 PRIVATE INSURANCES
Iowa MEDICAID 0080200 PRIVATE INSURANCES
Iowa Other 1875119 PRIVATE INSURANCES
Iowa Other 08399 PRIVATE INSURANCES
Iowa MEDICAID 9183715 PRIVATE INSURANCES
Iowa Other 22006 PRIVATE INSURANCES

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