Provider Demographics
NPI:1871762757
Name:TIMOTHY J POSER DDS MS SC
Entity type:Organization
Organization Name:TIMOTHY J POSER DDS MS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:POSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:262-255-6255
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-0406
Mailing Address - Country:US
Mailing Address - Phone:262-255-6255
Mailing Address - Fax:262-255-6265
Practice Address - Street 1:W156 N11365 PILGRIM RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-0406
Practice Address - Country:US
Practice Address - Phone:262-255-6255
Practice Address - Fax:262-255-6265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty