Endodontic Specialists of Lacrosse Ltd

NPI #1972504843 in Onalaska, Wisconsin

Provider Information

NPI Number: 1972504843
Entity Type: Organization
Organization Name: Endodontic Specialists of Lacrosse Ltd
Primary Specialty: Dentist - Endodontics
Enumeration Date: Aug 2, 2005
Last Updated: Jul 21, 2022

Practice Location

Address: 2700 NATIONAL DR
Address 2: STE 102
City: Onalaska
State: Wisconsin
ZIP Code: 54650
Phone: (608) 783-3636

Authorized Official

Name: DR. DEREK B NORDEEN, DDS
Title: PRESIDENT OF CORPORATION
Phone: (608) 783-3636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X	Primary

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