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Organization
MDC MILWAUKEE, LLC
Active
Organization
MDC MILWAUKEE, LLC
Active
Other names
Funke Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD JOSEPH BOLKA IV CPA (CFO)
(920) 579-3188
Entity
Organization
Contact information
Practice address
4701 W NATIONAL AVE, MILWAUKEE, WI 53214-3521
(920) 579-3188
Mailing address
PO BOX 1658, FOND DU LAC, WI 54936-1658
(920) 579-3188
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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