Organization
1BUBON & ASSOCIATES, ORTHODONTICS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S BUBON (OFFICE MANAGER)
(262) 522-7447
Entity
Organization
Contact information
Practice address
1701 N MAYFAIR RD, SUITE C, WAUWATOSA, WI 53226-3046
(262) 522-7447
(262) 522-7448
Mailing address
N4W21680 BLUEMOUND RD, WAUKESHA, WI 53186-2943
(262) 522-7447
(262) 522-7448
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4015-15
WI
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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