| Organization Name: | LEIPNITZ DENTAL CLINIC, SC |
| NPI Number: | 1295922946 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TODD ALERON LEIPNITZ (PRESIDENT/OWNER) |
| Mailing Address: | 2521 Broadway St S Menomonie |
| State: | WI US |
| Postal Code: | 547513914 |
| Phone Number: | 7152357371 |
| Fax Number: | 7152357380 |
| NPI Enumeration Date: | 09/26/2007 |
| NPI Last Update Date: | 09/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 5165-015 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |