MEDICARE: DR. CHRISTOPHER JOHN TAMSEN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1001564-15	WI

General Provider Information

NPI Number	:	1316470172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JOHN TAMSEN D.D.S.

Provider Business Mailing Address
First Line	:	N88W17001 MAIN ST
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-2828
Country	:	US
Telephone Number	:	262-251-6070
Fax Number	:

Provider Business Practice Location Address
First Line	:	N88W17001 MAIN ST
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-2828
Country	:	US
Telephone Number	:	262-251-6070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2017
Last Update Date	:	03/10/2021

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