Provider Demographics
NPI:1497923999
Name:MOLITOR, TROY PETER (DMD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:PETER
Last Name:MOLITOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N MAYFAIR RD STE 750
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1307
Mailing Address - Country:US
Mailing Address - Phone:414-257-3366
Mailing Address - Fax:414-258-1390
Practice Address - Street 1:2600 N MAYFAIR RD STE 750
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1307
Practice Address - Country:US
Practice Address - Phone:414-257-3366
Practice Address - Fax:414-258-1390
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5697-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist