Individual
DR. BRENT NORMAN TOLLERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
210 W CAPITOL DR, MILWAUKEE, WI 53212-1123
(414) 288-2930
Mailing address
1437 N JEFFERSON ST APT 126, MILWAUKEE, WI 53202-2997
(952) 334-4479
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.031643
IL
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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