Provider Demographics
NPI:1578633590
Name:SUNNYSLOPE DENTAL CARE 1 LLP
Entity type:Organization
Organization Name:SUNNYSLOPE DENTAL CARE 1 LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRINZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-786-2566
Mailing Address - Street 1:13900 W NATIONAL AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-4525
Mailing Address - Country:US
Mailing Address - Phone:262-786-2566
Mailing Address - Fax:262-786-2839
Practice Address - Street 1:13900 W NATIONAL AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-4525
Practice Address - Country:US
Practice Address - Phone:262-786-2566
Practice Address - Fax:262-786-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty