| Brookfieldctd LLC | |
|
14335 W Capitol Dr Brookfield WI 53005-2396 | |
| (262) 783-3311 | |
| Not Available |
| Full Name | Brookfieldctd LLC |
|---|---|
| Speciality | Dentist |
| Location | 14335 W Capitol Dr, Brookfield, Wisconsin |
| Authorized Official Name and Position | Mitch Weiland (ASSISTANT CONTROLLER) |
| Authorized Official Contact | 6083430818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookfieldctd LLC 8025 Excelsior Dr Madison WI 53717-1900 Ph: (608) 343-0818 | Brookfieldctd LLC 14335 W Capitol Dr Brookfield WI 53005-2396 Ph: (262) 783-3311 |
| NPI Number | 1598346280 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598346280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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