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5542 W Fond Du Lac Ave Milwaukee WI 53216-1200 | |
(414) 464-1070 | |
(414) 464-3797 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 5542 W Fond Du Lac Ave, Milwaukee, Wisconsin |
Authorized Official Name and Position | Sham S Chandok (DENTIST) |
Authorized Official Contact | 4143787971 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5542 W Fond Du Lac Ave Milwaukee WI 53216-1200 Ph: (414) 464-1070 | 5542 W Fond Du Lac Ave Milwaukee WI 53216-1200 Ph: (414) 464-1070 |
NPI Number | 1235541236 |
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Provider Enumeration Date | 05/24/2014 |
Last Update Date | 06/16/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235541236 | NPI | - | NPPES |
1093974321 | Other | WI | PROVIDER NPI NUMBER |
1962569012 | Other | WI | PROVIDER NPI NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 3107-15 (Wisconsin) | Primary |
Pro Dental Wi 1 Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1838 S 15th St, Milwaukee, WI 53204 Phone: 414-455-8805 Fax: 414-455-8812 | |
Layton Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 W Layton Ave Ste 305, Milwaukee, WI 53207 Phone: 414-539-4005 Fax: 414-539-6007 | |
Doctors' Denture Systems Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 W Lincoln Ave, Milwaukee, WI 53207 Phone: 414-671-5720 Fax: 414-671-5745 |