Bazemore, Ada Y
Bazemore, Ada Y is an individual health care provider with primary practice located at 2555 N Martin Luther King Dr , Milwaukee WI 53212-2709. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Bazemore, Ada Y can be contacted via phone (414) 372-8080.Contact Information
Primary practice address
2555 N Martin Luther King Dr
Milwaukee WI 53212-2709
Phone: (414) 372-8080
Fax: (414) 562-8432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 10515-016 | Wisconsin |
Profile Details
| NPI number | 1689089740 |
|---|---|
| LBN Legal business name | Bazemore, Ada Y |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2014 |
| Last updated | Jun 27th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689089740 | NPPES |
| Wisconsin | Other | 000002690 | MEDICARE PTAN |
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