Healthcare Provider Details

I. General information

NPI: 1063622561
Provider Name (Legal Business Name): STANLEY I. SEHLER D.D.S, S.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
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 Code261QD0000X
TaxonomyDental Clinic/Center
License Number1838E
License Number StateWI

VIII. Authorized Official

Name: DR. STANLEY I SEHLER
Title or Position: PERIODONTIST
Credential:
Phone: 414-259-9440