MEDICARE: DR. WILLIAM T. ERBES 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	5001605-015	WI

General Provider Information

NPI Number	:	1720082175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM T. ERBES D.D.S.

Provider Business Mailing Address
First Line	:	101 FALLS RD
Second Line	:	STE 500
City	:	GRAFTON
State	:	WI
Zip	:	53024-2612
Country	:	US
Telephone Number	:	262-375-4111
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 FALLS RD
Second Line	:	STE 500
City	:	GRAFTON
State	:	WI
Zip	:	53024-2612
Country	:	US
Telephone Number	:	262-375-4111
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	08/11/2015

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