Organization
EASTBROOK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS R HENSCHEL D.D.S. (PRESIDENT)
(262) 796-1312
Entity
Organization
Contact information
Practice address
12660 W NORTH AVE, BROOKFIELD, WI 53005-4633
(262) 796-1312
(262) 796-1318
Mailing address
12660 W NORTH AVE, BROOKFIELD, WI 53005-4633
(262) 796-1312
(262) 796-1318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3324
WI
1223G0001X
General Practice Dentistry
Primary
5863
WI
Other
Enumeration date
01/30/2007
Last updated
08/22/2020
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