Provider Demographics
NPI:1871183251
Name:CLOUD 9 DENTISTRY SC
Entity Type:Organization
Organization Name:CLOUD 9 DENTISTRY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:SCHWIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-367-4245
Mailing Address - Street 1:3079 VILLAGE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8361
Mailing Address - Country:US
Mailing Address - Phone:262-367-4245
Mailing Address - Fax:
Practice Address - Street 1:3079 VILLAGE SQUARE DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8361
Practice Address - Country:US
Practice Address - Phone:262-367-4245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental