Individual provider · Type 1 NPI
Eddie Kiyoshi Brotkowski, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Fond Du Lac, WI
Practice location
464 S Hickory St Ste A
Fond Du Lac, WI 54935-5531
Fax (920) 923-0366
Mailing address
2425 W Kellogg Ave
West Peoria, IL 61604-5011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 1001767 (WI) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Other oral and maxillofacial surgery (dentist) providers in Fond Du Lac
About NPI 1003100470
Eddie Kiyoshi Brotkowski, DDS, MD's National Provider Identifier is 1003100470, issued on Jun 2, 2011. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Fond Du Lac, WI. The record was last updated on May 6, 2019.