Lake, Ulrich

Lake, Ulrich is an individual health care provider with primary practice located at 100 River Place Ste 110, Madison WI 53716. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Lake, Ulrich can be contacted via phone (608) 222-6160.

Contact Information

Primary practice address
100 River Place Ste 110 Madison WI 53716
Fax: (608) 222-6248
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 4288015 Wisconsin

Profile Details

NPI number 1821187683
LBN Legal business name Lake, Ulrich
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821187683 NPPES
Wisconsin MEDICAID 33762600

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