Provider Demographics
NPI:1386761583
Name:ACCOMMODENT DENTAL ASSOC. S.C.
Entity type:Organization
Organization Name:ACCOMMODENT DENTAL ASSOC. S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZEEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-272-8866
Mailing Address - Street 1:735 NORTH WATER STREET
Mailing Address - Street 2:SUITE 926
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202
Mailing Address - Country:US
Mailing Address - Phone:414-272-8866
Mailing Address - Fax:414-272-8831
Practice Address - Street 1:735 NORTH WATER STREET
Practice Address - Street 2:SUITE 926
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202
Practice Address - Country:US
Practice Address - Phone:414-272-8866
Practice Address - Fax:414-272-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty