Organization
WISCONSIN DENTAL GROUP,S.C.
Active
Other names
Forward Dental
Organization subpart
No
Provider details
NPI number
Authorized official
PETER YOUNG (VP)
(414) 357-2040
Entity
Organization
Contact information
Practice address
9052 N DEERBROOK TRL, MILWAUKEE, WI 53223-2474
(414) 357-2040
(414) 354-3177
Mailing address
9052 N DEERBROOK TRL, MILWAUKEE, WI 53223-2474
(414) 357-2040
(414) 354-3177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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