Kotlyarenko, Inna
Kotlyarenko, Inna is an individual health care provider with primary practice located at 10425 W North Ave Suite 335, Wauwatosa WI 53226. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kotlyarenko, Inna can be contacted via phone (414) 476-3909.Contact Information
Primary practice address
10425 W North Ave Suite 335
Wauwatosa WI 53226
Phone: (414) 476-3909
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3358 | Wisconsin |
Profile Details
| NPI number | 1144423427 |
|---|---|
| LBN Legal business name | Kotlyarenko, Inna |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1144423427 | NPPES |
| Wisconsin | MEDICAID | 33468300 |
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