Provider Demographics
NPI:1467591560
Name:LEHRER, WALTER EUGENE (DDS)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:EUGENE
Last Name:LEHRER
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 1:17585 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4365
Mailing Address - Country:US
Mailing Address - Phone:262-782-5141
Mailing Address - Fax:262-782-0656
Practice Address - Street 1:17585 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4365
Practice Address - Country:US
Practice Address - Phone:262-782-5141
Practice Address - Fax:262-782-0656
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5000181015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist