| Pewaukee Dental | |
|
1231 George Towne Dr Ste D Pewaukee WI 53072-2756 | |
| (563) 582-1448 | |
| Not Available |
| Full Name | Pewaukee Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1231 George Towne Dr Ste D, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Emmy Montes (CBO SUPERVISOR) |
| Authorized Official Contact | 5635821448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pewaukee Dental 40 Main St Ste 103 Dubuque IA 52001-7641 Ph: (563) 582-1448 | Pewaukee Dental 1231 George Towne Dr Ste D Pewaukee WI 53072-2756 Ph: (563) 582-1448 |
| NPI Number | 1437638103 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 07/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437638103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Secondary |
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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