Provider Demographics
NPI:1730301854
Name:GEARY DENTISTRY LLC
Entity Type:Organization
Organization Name:GEARY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-860-1500
Mailing Address - Street 1:12780 W NORTH AVE
Mailing Address - Street 2:STE A
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:262-860-1500
Mailing Address - Fax:262-860-0019
Practice Address - Street 1:12780 W NORTH AVE
Practice Address - Street 2:STE A
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005
Practice Address - Country:US
Practice Address - Phone:262-860-1500
Practice Address - Fax:262-860-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty