Provider Demographics
NPI:1972711505
Name:CZAPLICKI FAMILY DENTISTRY,S.C.
Entity type:Organization
Organization Name:CZAPLICKI FAMILY DENTISTRY,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CZAPLICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-427-9090
Mailing Address - Street 1:6191 S 108TH ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-2524
Mailing Address - Country:US
Mailing Address - Phone:414-427-9090
Mailing Address - Fax:414-427-8390
Practice Address - Street 1:6191 S 108TH ST.
Practice Address - Street 2:SUITE A
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2524
Practice Address - Country:US
Practice Address - Phone:414-427-9090
Practice Address - Fax:414-427-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty