# WAUKESHA PEDIATRIC DENTAL CARE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124168638
- **Authorized official:** DR. SUSANN B NORWICK DDS MS (DR CEO)
- **Authorized official phone:** (262) 542-8402

## Contact information

- **Practice address:** 2727 N GRANDVIEW BLVD, SUITE 206, WAUKESHA, WI 53188-1671
- **Practice address phone:** (262) 542-8402
- **Practice address fax:** (262) 542-4436
- **Mailing address:** 2727 N GRANDVIEW BLVD, SUITE 206, WAUKESHA, WI 53188-1671
- **Mailing address phone:** (262) 542-8402
- **Mailing address fax:** (262) 542-4436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 08/22/2020