| Elmbrook Family Dental | |
|
125 N Executive Dr Suite 105 Brookfield WI 53005-6070 | |
| (262) 784-7201 | |
| (262) 784-0542 |
| Full Name | Elmbrook Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 125 N Executive Dr, Brookfield, Wisconsin |
| Authorized Official Name and Position | Brandon Andrew Brunner (PRESIDENT) |
| Authorized Official Contact | 2627847201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elmbrook Family Dental 125 N Executive Dr Suite 105 Brookfield WI 53005-6070 Ph: (262) 784-7201 | Elmbrook Family Dental 125 N Executive Dr Suite 105 Brookfield WI 53005-6070 Ph: (262) 784-7201 |
| NPI Number | 1134448632 |
|---|---|
| Provider Enumeration Date | 05/24/2010 |
| Last Update Date | 05/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134448632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5526-015 (Wisconsin) | Primary |
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Elmbrook Family Dental, S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 N Executive Dr, Suite 105, Brookfield, WI 53005 Phone: 262-784-7201 Fax: 262-784-0542 | |
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