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Contact Information

BEAVER DAM ENT LLC
707 S UNIVERSITY AVE
BEAVER DAM, WI53916-3027
 Phone: 920-887-6383
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for BEAVER DAM ENT LLC · (Female)

NPI # 1124277009
Status Active
Credentials
Entity Individual
Enumeration date 09/16/2008
Last updated 01/23/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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