Grand Avenue Dental Care, Llc | |
1163 Grand Ave Hartford WI 53027-2458 | |
(262) 673-7826 | |
Not Available |
Full Name | Grand Avenue Dental Care, Llc |
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Speciality | Clinic/center - Dental |
Location | 1163 Grand Ave, Hartford, Wisconsin |
Authorized Official Name and Position | Leah Nicole Clancy (OWNER) |
Authorized Official Contact | 7087385438 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grand Avenue Dental Care, Llc 2505 N 84th St Wauwatosa WI 53226-1905 Ph: (708) 738-5438 | Grand Avenue Dental Care, Llc 1163 Grand Ave Hartford WI 53027-2458 Ph: (262) 673-7826 |
NPI Number | 1255102323 |
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Provider Enumeration Date | 01/09/2024 |
Last Update Date | 01/09/2024 |
Identifier | Type | State | Issuer |
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1255102323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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