Provider Demographics
NPI:1417081522
Name:FINK, WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:FINK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W LODGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1617
Mailing Address - Country:US
Mailing Address - Phone:414-228-7020
Mailing Address - Fax:414-228-0605
Practice Address - Street 1:505 W HISTORIC MITCHELL ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3510
Practice Address - Country:US
Practice Address - Phone:414-383-3200
Practice Address - Fax:414-383-2183
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1585G1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33539600Medicaid