| The Fun Kids Dentist, S.c. | |
|
16655 Bluemound Rd Suite 380 Brookfield WI 53005 | |
| (262) 786-1270 | |
| (262) 786-0023 |
| Full Name | The Fun Kids Dentist, S.c. |
|---|---|
| Speciality | Dentist |
| Location | 16655 Bluemound Rd, Brookfield, Wisconsin |
| Authorized Official Name and Position | Edward J. Trochlell (PRESIDENT/OWNER) |
| Authorized Official Contact | 2627861270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fun Kids Dentist, S.c. 16655 Bluemound Rd Suite 380 Brookfield WI 53005 Ph: (262) 786-1270 | The Fun Kids Dentist, S.c. 16655 Bluemound Rd Suite 380 Brookfield WI 53005 Ph: (262) 786-1270 |
| NPI Number | 1568522720 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568522720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5001405 (Wisconsin) | Primary |
| 122300000X | Dentist | 50011629 (Wisconsin) | Secondary |
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