| |
3520 W Oklahoma Ave Milwaukee WI 53215-4175 | |
(414) 645-0365 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 3520 W Oklahoma Ave, Milwaukee, Wisconsin |
Authorized Official Name and Position | Daniel Smith (PRACTICE PARTNER) |
Authorized Official Contact | 4146450365 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3520 W Oklahoma Ave Milwaukee WI 53215-4175 Ph: (414) 645-0365 | 3520 W Oklahoma Ave Milwaukee WI 53215-4175 Ph: (414) 645-0365 |
NPI Number | 1558023622 |
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Provider Enumeration Date | 10/06/2021 |
Last Update Date | 04/18/2023 |
Identifier | Type | State | Issuer |
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1558023622 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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