MEDICARE: DR. GEORGE VUKMIR 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	122300000X	Dentist	2432	WI

General Provider Information

NPI Number	:	1386736213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE VUKMIR D.D.S.

Provider Business Mailing Address
First Line	:	9993 W NORTH AVE
Second Line	:	#329
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2521
Country	:	US
Telephone Number	:	414-332-5530
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 E SILVER SPRING DR
Second Line	:
City	:	WHITEFISH BAY
State	:	WI
Zip	:	53217-5226
Country	:	US
Telephone Number	:	414-332-5530
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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