| Bruce Holmstrom D.d.s.,sc | |
|
5150 N Port Washington Rd Suite 201 Glendale WI 53217-5474 | |
| (414) 964-8850 | |
| (414) 964-8918 |
| Full Name | Bruce Holmstrom D.d.s.,sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5150 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Bruce E Holmstrom (OWNER) |
| Authorized Official Contact | 4149648850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce Holmstrom D.d.s.,sc 5150 N Port Washington Rd Suite 201 Glendale WI 53217-5474 Ph: (414) 964-8850 | Bruce Holmstrom D.d.s.,sc 5150 N Port Washington Rd Suite 201 Glendale WI 53217-5474 Ph: (414) 964-8850 |
| NPI Number | 1114029048 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114029048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5002167-015 (Wisconsin) | Primary |
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