| Familia Dental Mkemidtown Llc | |
|
5341 W Fond Du Lac Ave Milwaukee WI 53216-1365 | |
| (888) 988-4066 | |
| (847) 496-4850 |
| Full Name | Familia Dental Mkemidtown Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5341 W Fond Du Lac Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Koushan Azad (OWNER) |
| Authorized Official Contact | 8477011457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental Mkemidtown Llc 2050 E Algonquin Rd Schaumburg IL 60173-4144 Ph: (888) 988-4066 | Familia Dental Mkemidtown Llc 5341 W Fond Du Lac Ave Milwaukee WI 53216-1365 Ph: (888) 988-4066 |
| NPI Number | 1982086955 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 06/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982086955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1001130 (Illinois) | Primary |
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