| Tooth Town Dentistry For Kids | |
|
6025 N Green Bay Ave Glendale WI 53209-3811 | |
| (414) 797-0328 | |
| (414) 355-0242 |
| Full Name | Tooth Town Dentistry For Kids |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6025 N Green Bay Ave, Glendale, Wisconsin |
| Authorized Official Name and Position | Nathan Knutsen (OWNER) |
| Authorized Official Contact | 4147970328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Town Dentistry For Kids 6025 N Green Bay Ave Glendale WI 53209-3811 Ph: (414) 797-0328 | Tooth Town Dentistry For Kids 6025 N Green Bay Ave Glendale WI 53209-3811 Ph: (414) 797-0328 |
| NPI Number | 1942995667 |
|---|---|
| Provider Enumeration Date | 04/07/2023 |
| Last Update Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942995667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Bruce Holmstrom D.d.s.,sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5150 N Port Washington Rd, Suite 201, Glendale, WI 53217 Phone: 414-964-8850 Fax: 414-964-8918 | |
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