Organization
WADE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD JOHN WADE DDS (OWNER)
(262) 542-4466
Entity
Organization
Contact information
Practice address
1547 E RACINE AVE, WAUKESHA, WI 53186-6826
(262) 542-4466
(262) 542-6105
Mailing address
1547 E RACINE AVE, WAUKESHA, WI 53186-6826
(262) 542-4466
(262) 542-6105
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
W3829
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33684200
—
WI
Enumeration date
02/18/2016
Last updated
02/18/2016
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