Brotkowski, Eddie Kiyoshi

Brotkowski, Eddie Kiyoshi is an individual health care provider with primary practice located at 464 S Hickory St Ste A , Fond Du Lac WI 54935-5531. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Brotkowski, Eddie Kiyoshi can be contacted via phone (920) 923-0111.

Contact Information

Primary practice address
464 S Hickory St Ste A Fond Du Lac WI 54935-5531
Phone: (920) 923-0111
Fax: (920) 923-0366
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1001767 Wisconsin

Profile Details

NPI number 1003100470
LBN Legal business name Brotkowski, Eddie Kiyoshi
Credentials D.D.S., M.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2011
Last updated May 6th, 2019 - about 5 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.

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