Provider Demographics
NPI:1134340581
Name:SVANG, EINAR CARL II (DDS)
Entity type:Individual
Prefix:DR
First Name:EINAR
Middle Name:CARL
Last Name:SVANG
Suffix:II
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 1:827 S ROCHESTER ST
Mailing Address - Street 2:STE 112
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-1652
Mailing Address - Country:US
Mailing Address - Phone:262-363-4141
Mailing Address - Fax:262-363-7209
Practice Address - Street 1:827 S ROCHESTER ST
Practice Address - Street 2:STE 112
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-1652
Practice Address - Country:US
Practice Address - Phone:262-363-4141
Practice Address - Fax:262-363-7209
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI43821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice