Organization
DENTAL ASSOCIATES LTD OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT BAUER (DIRECTOR OF PFS DEPT)
(414) 808-3020
Entity
Organization
Contact information
Practice address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3196
(414) 778-5274
(414) 777-3229
Mailing address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3196
(414) 778-5274
(414) 777-3229
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
03/24/2011
Last updated
11/15/2022
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