Jackson Family Dentistry Llc | |
N168w20060 Main St Jackson WI 53037-9382 | |
(262) 677-3003 | |
(262) 677-1641 |
Full Name | Jackson Family Dentistry Llc |
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Speciality | Dentist - General Practice |
Location | N168w20060 Main St, Jackson, Wisconsin |
Authorized Official Name and Position | Scott William Charmoli (OWNER) |
Authorized Official Contact | 2626773003 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jackson Family Dentistry Llc N168w20060 Main St Jackson WI 53037-9382 Ph: (262) 677-3003 | Jackson Family Dentistry Llc N168w20060 Main St Jackson WI 53037-9382 Ph: (262) 677-3003 |
NPI Number | 1114317815 |
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Provider Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |
Identifier | Type | State | Issuer |
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1114317815 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 3671-15 (Wisconsin) | Primary |
Bloy Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: W213n16755 Glen Brooke Dr, Jackson, WI 53037 Phone: 262-677-4990 | |
Jackson Town & Country Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: N168 W20566 Main St, Jackson, WI 53037 Phone: 262-444-0600 |