Organization
BRUCE HOLMSTROM D.D.S.,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE E HOLMSTROM D.D.S (OWNER)
(414) 964-8850
Entity
Organization
Contact information
Practice address
5150 N PORT WASHINGTON RD, SUITE 201, GLENDALE, WI 53217-5474
(414) 964-8850
(414) 964-8918
Mailing address
5150 N PORT WASHINGTON RD, SUITE 201, GLENDALE, WI 53217-5474
(414) 964-8850
(414) 964-8918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5002167-015
WI
Other
Enumeration date
09/01/2006
Last updated
08/22/2020
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