Provider Demographics
NPI:1770193849
Name:JOSE L. BARTOLOMEI, D.D.S., S.C.
Entity Type:Organization
Organization Name:JOSE L. BARTOLOMEI, D.D.S., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARTOLOMEI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-431-1595
Mailing Address - Street 1:4000 W HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-1045
Mailing Address - Country:US
Mailing Address - Phone:414-431-1595
Mailing Address - Fax:414-431-1576
Practice Address - Street 1:4000 W HOWARD AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-1045
Practice Address - Country:US
Practice Address - Phone:414-431-1595
Practice Address - Fax:414-431-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty