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BRUCE F ANDREKUS, DDS,SC

Dental Providers Dentist Dental Public Health

Provider NPI: 1104942432

Organization Information:
Organization Name:  BRUCE F ANDREKUS, DDS,SC
Organization is not Subpart
Authorized Official:  BRUCE  ANDREKUS  PRESIDENT  262-652-7956

Practice Location:
3726 ROOSEVELT RD  KENOSHA, WI 53142-1900 US
Tel: 262-652-7956  Fax: --

Business Mailing Address:
3726 ROOSEVELT RD  KENOSHA, WI 53142-1900 US
Tel: --  Fax: --

NPI Information:
NPI: 1104942432
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223D0001XDental Providers
Dentist
Dental Public Health
WI3650

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 1223D0001X

Type:

Classification:



Definition:



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