Dahlie, John William
Dahlie, John William is an individual health care provider with primary practice located at 106 W 5Th St , Shawano WI 54166. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Dahlie, John William can be contacted via phone (715) 524-4913.Contact Information
Primary practice address
106 W 5Th St
Shawano WI 54166
Phone: (715) 524-4913
Fax: (715) 524-6736
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2526 | Wisconsin |
Profile Details
| NPI number | 1164640066 |
|---|---|
| LBN Legal business name | Dahlie, John William |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1164640066 | NPPES |
| Wisconsin | MEDICAID | 33418500 |
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