Individual
DR. MARK DANIEL HACKBARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12770 W NORTH AVE, BROOKFIELD, WI 53005-4628
(262) 782-6311
(262) 782-6770
Mailing address
12770 W NORTH AVE, BROOKFIELD, WI 53005-4628
(262) 782-6311
(262) 782-6770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2479
WI
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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