Provider Demographics
NPI:1174648398
Name:FOTSCH, JAMES PARTICK (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PARTICK
Last Name:FOTSCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:W178N9201 WATERTOWER PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051
Mailing Address - Country:US
Mailing Address - Phone:262-251-8704
Mailing Address - Fax:262-251-8341
Practice Address - Street 1:W178N9201 WATERTOWER PL
Practice Address - Street 2:SUITE 100
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051
Practice Address - Country:US
Practice Address - Phone:262-251-8704
Practice Address - Fax:262-251-8341
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry