Healthcare Provider Details

I. General information

NPI: 1699078683
Provider Name (Legal Business Name): STANLEY I SEHLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N MAYFAIR RD STE 705
MILWAUKEE WI
53226-1533
US

IV. Provider business mailing address

2300 N MAYFAIR RD STE 705
MILWAUKEE WI
53226-1533
US

V. Phone/Fax

Practice location:
  • Phone: 414-259-9440
  • Fax: 414-259-0589
Mailing address:
  • Phone: 414-259-9440
  • Fax: 414-259-0589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number1838E
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: