Edp of Wisconsin, Sc
NPI #1033671912 in Oconomowoc, Wisconsin
Provider Information
- NPI Number
- 1033671912
- Entity Type
- Organization
- Organization Name
- Edp of Wisconsin, Sc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ELITE DENTAL PARTNERS
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Apr 1, 2019
- Last Updated
- Sep 16, 2019
Practice Location
- Address
- 820 SUMMIT AVE
- City
- Oconomowoc
- State
- Wisconsin
- ZIP Code
- 53066-3973
- Phone
- (312) 800-1270
Authorized Official
- Name
- ROSEANNE BRUNENKANT
- Title
- DIRECTOR OF INTEGRATIONS
- Phone
- (312) 937-3619
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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