Provider Demographics
NPI:1316080773
Name:HAMPTON DENTAL ASSOCIATES S.C.
Entity type:Organization
Organization Name:HAMPTON DENTAL ASSOCIATES S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-464-9021
Mailing Address - Street 1:5323 W HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-5019
Mailing Address - Country:US
Mailing Address - Phone:414-464-9021
Mailing Address - Fax:414-464-6576
Practice Address - Street 1:5323 W HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-5019
Practice Address - Country:US
Practice Address - Phone:414-464-9021
Practice Address - Fax:414-464-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3057-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty