Organization
NORTHRIDGE DENTAL CENTER S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A FITCH D.D.S. (PRESIDENT)
(414) 354-9020
Entity
Organization
Contact information
Practice address
7906 N 76TH ST, MILWAUKEE, WI 53223-3916
(414) 354-9020
Mailing address
2327 W APPLE TREE RD, GLENDALE, WI 53209-3311
(414) 352-3839
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5001515-015
WI
Other
Enumeration date
06/17/2005
Last updated
08/22/2020
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