Organization
PARKWAY DENTAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS E KIELMA D.D.S. (OWNER)
(414) 649-3510
Entity
Organization
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY STE 104, MILWAUKEE, WI 53215-3660
(414) 649-3510
(414) 385-2854
Mailing address
2901 W KINNICKINNIC RIVER PKWY STE 104, MILWAUKEE, WI 53215-3660
(414) 649-3510
(414) 385-2854
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001656
WI
1223G0001X
General Practice Dentistry
5003
WI
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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