Organization · Type 2 NPI

Wisconsin Dental Group, S.c.

Pediatric Dentistry · Menomonee Falls, WI

NPI number 1578693149 Active

Practice location

N80W17707 Custer Ln
Menomonee Falls, WI 53051-3630

Fax (262) 524-9225

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.

7 other providers at this address

NPI record

NPI: 1578693149
Entity type: Organization (Type 2)
Issued: Mar 6, 2007
Last updated: Mar 14, 2022
Status: Active
Subpart: Yes of Wisconsin Dental Group, S.c.

Other names

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Forwarddental Menomonee Falls · 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 1578693149

Wisconsin Dental Group, S.c.'s National Provider Identifier is 1578693149, issued on Mar 6, 2007. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Menomonee Falls, WI. The record was last updated on Mar 14, 2022.