Organization
WISCONSIN ENDODONTIC GROUP, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNE MARIE HANSEN FERGUS DDS (ENDODONTIST/OWNER)
(414) 258-1500
Entity
Organization
Contact information
Practice address
2600 N. MAYFAIR RD., STE 240, WAUWATOSA, WI 53226
(414) 258-1500
(414) 258-9353
Mailing address
2600 N. MAYFAIR RD., STE 240, WAUWATOSA, WI 53226
(414) 258-1500
(414) 258-9353
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5002
IA
Other
Enumeration date
09/22/2008
Last updated
04/17/2014
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