| Brookfield Family Dentistry | |
|
17185 W North Ave Brookfield WI 53005-4428 | |
| (262) 821-1000 | |
| Not Available |
| Full Name | Brookfield Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17185 W North Ave, Brookfield, Wisconsin |
| Authorized Official Name and Position | Thomas Thaddeous Tang (PRESIDENT) |
| Authorized Official Contact | 2628211000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookfield Family Dentistry 17185 W North Ave Brookfield WI 53005-4428 Ph: (262) 821-1000 | Brookfield Family Dentistry 17185 W North Ave Brookfield WI 53005-4428 Ph: (262) 821-1000 |
| NPI Number | 1508035445 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 02/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508035445 | NPI | - | NPPES |
| 1386867679 | Other | WI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3801 (Wisconsin) | Primary |
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