| Sandberg Modern Dental Llc | |
|
6535 W North Ave Wauwatosa WI 53213-2016 | |
| (414) 258-8190 | |
| Not Available |
| Full Name | Sandberg Modern Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6535 W North Ave, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Matthew Sandberg (OWNER) |
| Authorized Official Contact | 4142588190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandberg Modern Dental Llc 6535 W North Ave Wauwatosa WI 53213-2016 Ph: (414) 258-8190 | Sandberg Modern Dental Llc 6535 W North Ave Wauwatosa WI 53213-2016 Ph: (414) 258-8190 |
| NPI Number | 1285029652 |
|---|---|
| Provider Enumeration Date | 04/02/2015 |
| Last Update Date | 04/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285029652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | WI 6664-15 (Wisconsin) | Primary |
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