Organization
BROOKFIELD DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY KEVIN (MANAGER)
(262) 873-0510
Entity
Organization
Contact information
Practice address
17585 W NORTH AVE STE 210, BROOKFIELD, WI 53045-4365
(262) 784-4222
Mailing address
920 INDIAN SPRING DR, DELAFIELD, WI 53018-2242
(262) 646-2771
(262) 646-2340
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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