Healthcare Provider Details

I. General information

NPI: 1588596142
Provider Name (Legal Business Name): CLAIRE MARIE OPSTEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5471 W WATERFORD LN
APPLETON WI
54913-8510
US

IV. Provider business mailing address

3315 RIDGECREST LN
KAUKAUNA WI
54130-4323
US

V. Phone/Fax

Practice location:
  • Phone: 920-731-7445
  • Fax:
Mailing address:
  • Phone: 920-809-9209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1002662
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: