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Organization
RENITA C BURRELL, DDS, MS, S.C.
Active
Organization
RENITA C BURRELL, DDS, MS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENITA C BURRELL DDS, MS (PERIODONTIST)
(262) 384-0092
Entity
Organization
Contact information
Practice address
2457 N MAYFAIR RD STE 102, MILWAUKEE, WI 53226-1405
(414) 257-1221
Mailing address
2457 N MAYFAIR RD STE 102, MILWAUKEE, WI 53226-1405
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6086-15
WI
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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