Familia Dental Mke Midtown Llc | |
5341 W Fond Du Lac Ave Milwakee WI 53216-1365 | |
(414) 871-0827 | |
(414) 871-0859 |
Full Name | Familia Dental Mke Midtown Llc |
---|---|
Speciality | Clinic/center - Dental |
Location | 5341 W Fond Du Lac Ave, Milwakee, Wisconsin |
Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING & PAYOR RELATIONS MAN) |
Authorized Official Contact | 8474537393 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Familia Dental Mke Midtown Llc 2050 E Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Familia Dental Mke Midtown Llc 5341 W Fond Du Lac Ave Milwakee WI 53216-1365 Ph: (414) 871-0827 |
NPI Number | 1083283626 |
---|---|
Provider Enumeration Date | 06/18/2021 |
Last Update Date | 06/18/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083283626 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |