Organization
ADVANCED DENTAL SPECIALISTS, LLC
Active
Other names
Advanced Dental Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
PETER YOUNG (VICE PRESIDENT OF OPERATIONS)
(414) 357-2040
Entity
Organization
Contact information
Practice address
9052 N DEERBROOK TRL, MILWAUKEE, WI 53223-2474
(414) 357-2040
Mailing address
9052 N DEERBROOK TRL, MILWAUKEE, WI 53223-2474
(414) 357-2040
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/11/2008
Last updated
03/31/2010
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