Provider Demographics
NPI:1720645708
Name:PELEHAC, ANGELA M (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:PELEHAC
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2966 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2657
Mailing Address - Country:US
Mailing Address - Phone:715-514-3333
Mailing Address - Fax:
Practice Address - Street 1:2966 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-2657
Practice Address - Country:US
Practice Address - Phone:715-514-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002060151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics