Provider Demographics
NPI:1356337356
Name:ENGEL, DENNIS WALTER (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:WALTER
Last Name:ENGEL
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 1:7604 W MEQUON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-3215
Mailing Address - Country:US
Mailing Address - Phone:262-242-8929
Mailing Address - Fax:262-242-9941
Practice Address - Street 1:7604 W MEQUON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-3215
Practice Address - Country:US
Practice Address - Phone:262-242-8929
Practice Address - Fax:262-242-9941
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001538-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist