IndividualActive
Eddie Brotkowski, D.D.S., M.D.
NPI 1003100470 · Oral and Maxillofacial Surgery (Dentist) · Fond Du Lac, WI
Provider details
- NPI number
- 1003100470
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- D.D.S., M.D.
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Dental Providers
Student, Health Care
Practice location
464 S Hickory St Ste a
Fond Du Lac, WI 54935-5531
Phone: (920) 923-0111
Fax: (920) 923-0366
Approximate (ZIP-level) locationGet directions
Mailing address
2425 W Kellogg Ave
West Peoria, IL 61604-5011
Registry dates
- Enumerated
- 2011-06-02
- Last updated
- 2019-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.