Provider Demographics
NPI:1932560604
Name:DR PETER LOTOWSKI LLC
Entity Type:Organization
Organization Name:DR PETER LOTOWSKI LLC
Other - Org Name:WISCONSIN DENTAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:608-834-6321
Mailing Address - Street 1:1260 W MAIN ST # 1
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1930
Mailing Address - Country:US
Mailing Address - Phone:608-834-6321
Mailing Address - Fax:
Practice Address - Street 1:1260 W MAIN ST # 1
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1930
Practice Address - Country:US
Practice Address - Phone:608-834-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty