Dr. Mark Steven Moeller
Dentist Pediatric Dentist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
Dr. Mark Steven Moeller
Dentist Pediatric Dentist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
(608) 782-7300
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About
Features
Specialties
- Dentist
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Mark Steven Moeller
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
Second Address
- Dr. Mark Steven Moeller
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 122300000X | Dentist | 09067 | IA |
| N | 122300000X | Dentist | 1001156 | WI |
| Y | 1223P0221X | Pediatric Dentist | 1001156 | WI |
| N | 1223P0221X | Pediatric Dentist | S25 | MN |
National Provider Identifier
| NPI | 1083895510 |
|---|---|
| Provider Name | Dr. Mark Steven Moeller |
| First Address | La Crosse, WI 54601-5429 |
| Second Address | La Crosse, WI 54601-5429 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/11/2007 |
| Last Update Date | 19/12/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.