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General NPI Number Information
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NPI Number | 1396104097
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Entity Type | Organization
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Legal Business Name | GEORGEANN C. VARGAS DDS, LTD
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 601 STATE ROAD 35
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City | CENTURIA
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State | WI
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Zip | 54824-9014
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Country | US
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Telephone | 715-646-2161
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Fax | 715-646-2023
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Provider Business Mailing Address
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Address Line | 601 STATE ROAD 35 PO BOX 459
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City | CENTURIA
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State | WI
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Zip | 54824-9014
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Country | US
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Telephone | 715-646-2161
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Fax | 715-646-2023
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGEANN C VARGAS
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Credential | DDS
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Telephone | 715-646-2161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 1001112
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License Number State | WI
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