| Keystone Bayview Llc | |
|
3380 S Kinnickinnic Ave Milwaukee WI 53207-3159 | |
| (262) 873-0510 | |
| Not Available |
| Full Name | Keystone Bayview Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3380 S Kinnickinnic Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Christopher Potrykus (OWNER) |
| Authorized Official Contact | 2628730510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Bayview Llc Po Box 180163 Delafield WI 53018-0163 Ph: (262) 873-0510 | Keystone Bayview Llc 3380 S Kinnickinnic Ave Milwaukee WI 53207-3159 Ph: (262) 873-0510 |
| NPI Number | 1609592534 |
|---|---|
| Provider Enumeration Date | 10/12/2022 |
| Last Update Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609592534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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