| Ahp 004 Llc | |
|
W236s7050 Big Bend Dr Ste 7 Big Bend WI 53103-9497 | |
| (262) 662-1111 | |
| Not Available |
| Full Name | Ahp 004 Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | W236s7050 Big Bend Dr Ste 7, Big Bend, Wisconsin |
| Authorized Official Name and Position | Kate Mantay (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2626494900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahp 004 Llc 15285 Watertown Plank Rd Ste 200 Elm Grove WI 53122-2339 Ph: (262) 649-4900 | Ahp 004 Llc W236s7050 Big Bend Dr Ste 7 Big Bend WI 53103-9497 Ph: (262) 662-1111 |
| NPI Number | 1568275071 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 01/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568275071 | NPI | - | NPPES |
| 1992320196 | Other | NPI | |
| 1114779501 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Woodland Dental Grp., Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: W232s7590 Woodland Ln, Big Bend, WI 53103 Phone: 262-662-3066 Fax: 262-662-2070 |