Organization
MDC MILWAUKEE, LLC
Active
Other names
Funke Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD JOSEPH BOLKA IV CPA (CFO)
(920) 579-3188
Entity
Organization
Contact information
Practice address
4701 W NATIONAL AVE, MILWAUKEE, WI 53214-3521
(920) 579-3188
Mailing address
PO BOX 1658, FOND DU LAC, WI 54936-1658
(920) 579-3188
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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