Sandberg Modern Dental LLC

NPI #1285029652 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1285029652
Entity Type: Organization
Organization Name: Sandberg Modern Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 2, 2015
Last Updated: Apr 2, 2015

Practice Location

Address: 6535 W NORTH AVE
City: Wauwatosa
State: Wisconsin
ZIP Code: 53213-2016
Phone: (414) 258-8190

Authorized Official

Name: DR. MATTHEW SANDBERG, DMD
Title: OWNER
Phone: (414) 258-8190

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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