MEDICARE: MR. WALTER EUGENE LEHRER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5000181015	WI

General Provider Information

NPI Number	:	1467591560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WALTER EUGENE LEHRER DDS

Provider Business Mailing Address
First Line	:	17585 W NORTH AVE
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4365
Country	:	US
Telephone Number	:	262-782-5141
Fax Number	:	262-782-0656

Provider Business Practice Location Address
First Line	:	17585 W NORTH AVE
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4365
Country	:	US
Telephone Number	:	262-782-5141
Fax Number	:	262-782-0656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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