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General NPI Number Information
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NPI Number | 1366695710
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Entity Type | Individual
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Provider Name | JOHN T BITNER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 714 SUMMIT AVE
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City | OCONOMOWOC
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State | WI
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Zip | 53066-3827
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Country | US
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Telephone | 262-567-9116
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Fax | 262-567-5870
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Provider Business Mailing Address
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Address Line | 990 HWY 83
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City | HARTFORD
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State | WI
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Zip | 53027-8808
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Country | US
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Telephone | 262-966-0055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6327
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License Number State | WI
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