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1825 N Martin Luther King Dr Milwaukee WI 53212-3673 | |
(414) 372-7374 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1825 N Martin Luther King Dr, Milwaukee, Wisconsin |
Authorized Official Name and Position | Roseanne Brunenkant (DIRECTOR OF INTEGRATIONS) |
Authorized Official Contact | 3129373619 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 Ph: (312) 937-3619 | 1825 N Martin Luther King Dr Milwaukee WI 53212-3673 Ph: (414) 372-7374 |
NPI Number | 1932752862 |
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Provider Enumeration Date | 07/19/2019 |
Last Update Date | 09/16/2019 |
Identifier | Type | State | Issuer |
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1932752862 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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