Organization · Type 2 NPI

Wisconsin Dental Group, S.c.

General Practice Dentistry · Hales Corners, WI

NPI number 1073261509 Active

Practice location

5250 S 108th St Ste 200
Hales Corners, WI 53130-1321

Fax (414) 327-6304

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Another provider at this address

Justin Peters, DDSGeneral Practice Dentistry Hales Corners, WI NPI 1295221596

Other general practice dentistry providers in Hales Corners

See all in Hales Corners →

NPI record

NPI: 1073261509
Entity type: Organization (Type 2)
Issued: Mar 14, 2022
Last updated: Mar 14, 2022
Status: Active
Subpart: Yes of Wisconsin Dental Group, S.c.

Other names

Forwarddental Hales Corners · 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 1073261509

Wisconsin Dental Group, S.c.'s National Provider Identifier is 1073261509, issued on Mar 14, 2022. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Hales Corners, WI. The record was last updated on Mar 14, 2022.