Brian Hart, DDS

NPI #1457885873 in Portage, Wisconsin

Provider Information

NPI Number: 1457885873
Entity Type: Individual
Name: Brian Hart, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: DDS
Enumeration Date: Apr 12, 2017
Last Updated: Apr 12, 2017

Practice Location

Address: 225 GUNDERSON DR
City: Portage
State: Wisconsin
ZIP Code: 53901-3430
Phone: (608) 697-2484

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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