Douglas D Podoll DDS Sc

NPI #1063563674 in Baldwin, Wisconsin

Provider Information

NPI Number: 1063563674
Entity Type: Organization
Organization Name: Douglas D Podoll DDS Sc
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jan 12, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1460 10TH AVE
City: Baldwin
State: Wisconsin
ZIP Code: 54002
Phone: (715) 684-5858

Authorized Official

Name: DOUGLAS D PODOLL, DDS
Title: PRESIDENT
Phone: (715) 684-5858

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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Organizations

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