Provider Demographics
NPI:1528823069
Name:CHAMBERS, DAWN MARIE (RDH)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:TROIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:N5285 ASH LN
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-5325
Mailing Address - Country:US
Mailing Address - Phone:608-234-2484
Mailing Address - Fax:
Practice Address - Street 1:W3275 WOLF RIVER DR
Practice Address - Street 2:
Practice Address - City:KESHENA
Practice Address - State:WI
Practice Address - Zip Code:54135-9202
Practice Address - Country:US
Practice Address - Phone:715-799-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6822-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist