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General NPI Number Information
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NPI Number | 1871305466
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Entity Type | Organization
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Legal Business Name | JOHN T BITNER DDS LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 888 THACKERAY TRAIL STE 214
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City | OCONOMOWOC
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State | WI
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Zip | 53066
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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 | 888 THACKERAY TRAIL STE 214
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City | OCONOMOWOC
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State | WI
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Zip | 53066
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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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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | JOHN BITNER
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Credential | DDS
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Telephone | 262-567-9116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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