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NPI Code Detail

MEDICARE: DR. PAUL MARK SANDVICK D.D.S.

MEDICARE:  DR. PAUL MARK SANDVICK  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
11223G0001XGeneral Practice Dentistry2726WI

General Provider Information

NPI Number : 1811072242
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL MARK SANDVICK D.D.S.
Provider Business Mailing Address
First Line : 6070 N PORT WASHINGTON RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53217-4524
Country : US
Telephone Number : 414-962-4100
Fax Number :
Provider Business Practice Location Address
First Line : 6070 N PORT WASHINGTON RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53217-4524
Country : US
Telephone Number : 414-962-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. PAUL MARK SANDVICK D.D.S.” Practice Location

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