| Familia Dental Mkemitchell Llc | |
|
821 S Layton Blvd Milwaukee WI 53215-1225 | |
| (888) 988-4066 | |
| (847) 496-4850 |
| Full Name | Familia Dental Mkemitchell Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 821 S Layton Blvd, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Brandon Taylor (CREDENTIALING & PAYOR RELATIONS MGR) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental Mkemitchell Llc 2050 E Algonquin Rd Schaumburg IL 60173-4144 Ph: (888) 988-4066 | Familia Dental Mkemitchell Llc 821 S Layton Blvd Milwaukee WI 53215-1225 Ph: (888) 988-4066 |
| NPI Number | 1609259266 |
|---|---|
| Provider Enumeration Date | 07/01/2015 |
| Last Update Date | 07/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609259266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1001130 (Wisconsin) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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