Provider Demographics
NPI:1013958107
Name:NEUSCHAEFER, WILLIAM BRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRIAN
Last Name:NEUSCHAEFER
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 1:18280 HIGH MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3873
Mailing Address - Country:US
Mailing Address - Phone:262-789-7474
Mailing Address - Fax:262-789-7474
Practice Address - Street 1:125 N EXECUTIVE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-6070
Practice Address - Country:US
Practice Address - Phone:262-784-7201
Practice Address - Fax:262-784-0542
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001902-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice