Whalio Doctors

NPI 1003100470

Eddie Kiyoshi Brotkowski, DDSMD

Practitioner Oral and Maxillofacial Surgery (Dentist) Fond Du Lac, WI

Practice location

Address
464 S Hickory St STE a, Fond Du Lac, WI 54935-5531
Phone
(920) 923-0111
Fax
(920) 923-0366
Mailing address
2425 W Kellogg Ave, West Peoria, IL 61604-5011

Registered specialties (2)

Oral and Maxillofacial Surgery (Dentist) Primary
Dental Providers Taxonomy 1223S0112X Licence 1001767 (WI)
Student in an Organized Health Care Education/Training Program
Student, Health Care Taxonomy 390200000X

Registry record

NPI
1003100470
Entity type
Individual
Sex (as registered)
Male
NPI issued
2 Jun 2011
Record last updated
6 May 2019

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.