Individual
NATHAN TRUCKENBROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(415) 205-8401
Mailing address
4240 S RAVINIA DR APT 102, GREENFIELD, WI 53221-5714
(415) 205-8401
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1000997-15
WI
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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