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Organization
INTEGRATIVE DENTAL SOLUTIONS LLC
Active
Organization
INTEGRATIVE DENTAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPRIYA SHETTY DDS (OWNER)
(262) 691-4555
Entity
Organization
Contact information
Practice address
N35W23770 CAPITOL DR STE E, PEWAUKEE, WI 53072-2639
(262) 691-4555
(262) 691-4579
Mailing address
N35W23770 CAPITOL DR STE E, PEWAUKEE, WI 53072-2639
(262) 691-4555
(262) 691-4579
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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