Provider Demographics
NPI:1013096387
Name:SCHIFFLEGER, BRUNO ELMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:ELMER
Last Name:SCHIFFLEGER
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:W3790 POTTER RD
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4038
Mailing Address - Country:US
Mailing Address - Phone:262-723-2643
Mailing Address - Fax:
Practice Address - Street 1:255 HAVENWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-1917
Practice Address - Country:US
Practice Address - Phone:262-248-8899
Practice Address - Fax:262-248-3639
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4000999-0151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics