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Organization

THE FUN KIDS DENTIST, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD J. TROCHLELL D.D.S. (PRESIDENT/OWNER)
(262) 786-1270
Entity
Organization

Contact information

Practice address
16655 BLUEMOUND RD, SUITE 380, BROOKFIELD, WI 53005
(262) 786-1270
(262) 786-0023
Mailing address
16655 BLUEMOUND RD, SUITE 380, BROOKFIELD, WI 53005
(262) 786-1270
(262) 786-0023

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
50011629
WI
122300000X
Dentist
Primary
5001405
WI

Other

Enumeration date
12/11/2006
Last updated
05/27/2014
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