Provider Demographics
NPI:1124249578
Name:EINAR C. SVANG II DDS SC
Entity type:Organization
Organization Name:EINAR C. SVANG II DDS SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EINAR
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:SVANG
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-363-4141
Mailing Address - Street 1:827 S ROCHESTER ST
Mailing Address - Street 2:STE 112
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-1652
Mailing Address - Country:US
Mailing Address - Phone:262-363-4141
Mailing Address - Fax:262-363-7209
Practice Address - Street 1:827 S ROCHESTER ST
Practice Address - Street 2:STE 112
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-1652
Practice Address - Country:US
Practice Address - Phone:262-363-4141
Practice Address - Fax:262-363-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI43821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty