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Contact Information

BLAKE J EDINGER, DDS
15397 STATE HIGHWAY 32
LAKEWOOD, WI54138
 Phone: 715-276-6321
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for BLAKE J EDINGER · (Male)

NPI # 1750376968
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/14/2005
Last updated 10/28/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 3874
  • WI Medicaid 100065650
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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