| Progressive Pediatric Dentist Sc | |
|
8375 S Howell Ave #201 Oak Creek WI 53154-8344 | |
| (414) 768-1020 | |
| (414) 768-8866 |
| Full Name | Progressive Pediatric Dentist Sc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8375 S Howell Ave, Oak Creek, Wisconsin |
| Authorized Official Name and Position | Steven Robert Chybowski (DENTIST) |
| Authorized Official Contact | 4147681020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Pediatric Dentist Sc 8375 S Howell Ave #201 Oak Creek WI 53154-8344 Ph: (414) 768-1020 | Progressive Pediatric Dentist Sc 8375 S Howell Ave #201 Oak Creek WI 53154-8344 Ph: (414) 768-1020 |
| NPI Number | 1174638142 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 03/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174638142 | NPI | - | NPPES |
| 38393100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4919 (Wisconsin) | Primary |
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