| Healthdrive Dental Group | |
|
200 S Executive Dr Suite 101 Brookfield WI 53005-4216 | |
| (414) 535-8134 | |
| (414) 535-8135 |
| Full Name | Healthdrive Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 200 S Executive Dr, Brookfield, Wisconsin |
| Authorized Official Name and Position | Alec H. Jaret (OWNER/PRESIDENT) |
| Authorized Official Contact | 6179646681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthdrive Dental Group 100 Crossing Blvd Suite 300 Framingham MA 01702-5555 Ph: (617) 964-6681 | Healthdrive Dental Group 200 S Executive Dr Suite 101 Brookfield WI 53005-4216 Ph: (414) 535-8134 |
| NPI Number | 1710919824 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 01/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710919824 | NPI | - | NPPES |
| 38388700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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