Mark R. Boettcher, DDS

General Practice Dentistry · Brookfield, WI

Individual Active NPI

NPI number 1083826390

Practice location

16905 West Wisconsin Ave
Brookfield, WI 53005-5729
Phone
(262) 754-4480
Fax
(262) 754-4470

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NPI record

NPI
1083826390
Entity type
Individual (Type 1)
Enumeration date
May 7, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 5001903015 WI

About Dr. Boettcher

Mark R. Boettcher, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 16905 West Wisconsin Ave, Brookfield, WI 53005-5729. The NPI number 1083826390 was assigned on May 7, 2007 and the record was last updated on July 8, 2007.

Dr. Boettcher lists a license in the registry: #5001903015 (WI) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark R. Boettcher, DDS?

The NPI number is 1083826390.

What is the phone number of Dr. Boettcher?

The phone number listed for the practice location is (262) 754-4480.

Where is Dr. Boettcher located?

16905 West Wisconsin Ave, Brookfield, WI 53005-5729.

What is the taxonomy code for Dr. Boettcher?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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