Individual
FREDY CAM-KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8200 W SILVER SPRING DR, MILWAUKEE, WI 53218-2552
(414) 760-3900
(414) 464-7258
Mailing address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 267-6641
(414) 372-7425
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001596-15
WI
1223G0001X
General Practice Dentistry
6001596-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100282351
—
WI
Enumeration date
06/28/2024
Last updated
07/16/2024
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