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1417 S 108th St Milwaukee WI 53214-4012 | |
| (414) 771-5588 | |
| (414) 771-3564 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1417 S 108th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Helene Frank (OFFICE MANAGER) |
| Authorized Official Contact | 4147715588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1417 S 108th St Milwaukee WI 53214-4012 Ph: () - | 1417 S 108th St Milwaukee WI 53214-4012 Ph: (414) 771-5588 |
| NPI Number | 1316455322 |
|---|---|
| Provider Enumeration Date | 01/12/2018 |
| Last Update Date | 01/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316455322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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