Organization
KIM TRAN-WERTZ DDS MS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM TRAN-WERTZ DDS MS (DENTIST)
(262) 782-2300
Entity
Organization
Contact information
Practice address
12720 W NORTH AVE, BROOKFIELD, WI 53005-4637
(262) 782-2300
(262) 782-2313
Mailing address
12720 W NORTH AVE, BROOKFIELD, WI 53005-4637
(262) 782-2300
(262) 782-2313
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4384-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33770200
—
WI
Enumeration date
11/24/2010
Last updated
11/24/2010
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