Organization · Type 2 NPI

Wisconsin Dental Group, S.c.

Pediatric Dentistry · Milwaukee, WI

NPI number 1043340417 Active

Practice location

1575 N Rivercenter Dr Ste 200
Milwaukee, WI 53212-3965

Fax (414) 276-1715

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Another provider at this address

Svetlana X. Yun, DMDDentist Milwaukee, WI NPI 1194457408

NPI record

NPI: 1043340417
Entity type: Organization (Type 2)
Issued: Mar 6, 2007
Last updated: Apr 15, 2022
Status: Active
Subpart: Yes of Wisconsin Dental Group, S.c.

Other names

<unavail>
Forwarddental Rivercenter · doing business as

Authorized official

Celia Hayes
Credentialing Coordinator
(217) 540-2100

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043340417

Wisconsin Dental Group, S.c.'s National Provider Identifier is 1043340417, issued on Mar 6, 2007. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Milwaukee, WI. The record was last updated on Apr 15, 2022.