Durtsche, Timothy Brekke
Durtsche, Timothy Brekke is an individual health care provider with primary practice located at 615 10Th St S , La Crosse WI 54601-4768. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Durtsche, Timothy Brekke can be contacted via phone (608) 784-7319.Contact Information
Primary practice address
615 10Th St S
La Crosse WI 54601-4768
Phone: (608) 784-7319
Fax: (608) 784-4384
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 2244 | Wisconsin |
Profile Details
| NPI number | 1447254305 |
|---|---|
| LBN Legal business name | Durtsche, Timothy Brekke |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| 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 | 1447254305 | NPPES |
| Wisconsin | MEDICAID | 33388200(PERFORMING) | |
| Wisconsin | MEDICAID | 38365100 (BILLING#) |
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