NPI 1104885482

Wauwatosa Dental Group Sc

Organisation Dentist Wauwatosa, WI

Practice location

Address: 2600 N Mayfair Rd Suite 750, Wauwatosa, WI 53226-1309
Phone: (414) 257-3366
Fax: (414) 258-1390

Authorised official

Name: John M Dickinson
Title: President Owner
Phone: (414) 257-3366

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X

Other Dentist providers in Wisconsin →

Registry record

NPI: 1104885482
Entity type: Organization
NPI issued: 23 Mar 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.