Vandehaar, Kent

Vandehaar, Kent is an sole proprietor health care provider with primary practice located at 123 W Willow St , Chippewa Falls WI 54729-2329. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Vandehaar, Kent can be contacted via phone (715) 723-5688.

Contact Information

Primary practice address
123 W Willow St Chippewa Falls WI 54729-2329
Fax: (715) 723-4039
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2836 Wisconsin

Profile Details

NPI number 1275743023
LBN Legal business name Vandehaar, Kent
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2007
Last updated Jul 9th, 2007 - about 18 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 1275743023 NPPES
Wisconsin MEDICAID 33432500

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