MEDICARE: DR. CHRISTINE SUE TEMPAS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2330	WI

General Provider Information

NPI Number	:	1598763047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE SUE TEMPAS D.D.S.

Provider Business Mailing Address
First Line	:	311 FOND DU LAC AVE
Second Line	:
City	:	SHEBOYGAN FALLS
State	:	WI
Zip	:	53085-1217
Country	:	US
Telephone Number	:	920-467-4234
Fax Number	:	920-467-4984

Provider Business Practice Location Address
First Line	:	311 FOND DU LAC AVE
Second Line	:
City	:	SHEBOYGAN FALLS
State	:	WI
Zip	:	53085-1217
Country	:	US
Telephone Number	:	920-467-4234
Fax Number	:	920-467-4984

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/16/2007

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