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General NPI Number Information
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NPI Number | 1295656726
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Entity Type | Organization
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Legal Business Name | SIGNATURE DENTISTRY BROOKFIELD LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 15375 W BLUEMOUND RD STE 150
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City | BROOKFIELD
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State | WI
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Zip | 53005-4008
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Country | US
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Telephone | 414-400-3343
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Fax |
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Provider Business Mailing Address
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Address Line | 133 E BEECHWOOD DR
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City | MEQUON
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State | WI
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Zip | 53092-5971
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Country | US
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Telephone | 414-400-3343
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | CAMILLE SIMPER
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Credential | MBA
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Telephone | 414-400-3343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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