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Brian Hart, DDS
Student in an Organized Health Care Education/Training Program in Portage, Wisconsin
NPI 1457885873

Brian Hart is a Student in an Organized Health Care Education/Training Program based in Portage, WI. Brian Hart practices in Portage, WI and has the professional credentials of DDS. The NPI Number for Brian Hart is 1457885873 and holds a License No. (Wisconsin).

The current practice location address for Brian Hart is 225 Gunderson Dr, Portage, WI and can be reached out via phone at 608-697-2484.

Location: 225 Gunderson Dr, Portage, WI, 53901-3430
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457885873
Provider Name
Brian Hart
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
225 Gunderson Dr, Portage, WI, 53901-3430
Phone Number
608-697-2484
Fax Number
Provider Enumeration Date
04/12/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
225 Gunderson Dr
City
Portage
State
Wisconsin
Zip
53901-3430
Phone Number
608-697-2484
Fax Number
person
Provider Business Mailing Address Details
Address
225 Gunderson Dr
City
Portage
State
Wisconsin
Zip
53901-3430
Phone Number
608-697-2484
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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