Individual
SUBRAMONY BHAGAVATHEESWARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5341 W FOND DU LAC AVE, MILWAUKEE, WI 53216-1365
(082) 741-4871
Mailing address
3660 S RIVERSHIRE DR APT 4, GREENFIELD, WI 53228-1167
(510) 962-1344
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001894-15
WI
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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