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Organization
RENNER AND MARTIN DDS SC
Active
Organization
RENNER AND MARTIN DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ROBERT RENNER DDS (OWNER)
(262) 549-3640
Entity
Organization
Contact information
Practice address
1111 DELAFIELD ST. #319, WAUKESHA, WI 53188-3407
(262) 549-3640
Mailing address
903 LYNNE COURT, WAUKESHA, WI 53186-3407
(262) 547-8780
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5002149-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33399400
BADGERCARE
WI
Enumeration date
05/03/2007
Last updated
08/22/2020
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