Organization
WAUWATOSA DENTAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M DICKINSON DDS (PRESIDENT OWNER)
(414) 257-3366
Entity
Organization
Contact information
Practice address
2600 N MAYFAIR RD, SUITE 750, WAUWATOSA, WI 53226-1309
(414) 257-3366
(414) 258-1390
Mailing address
2600 N MAYFAIR RD, SUITE 750, WAUWATOSA, WI 53226-1309
(414) 257-3366
(414) 258-1390
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/23/2006
Last updated
08/22/2020
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