| Lake Bluff Dental | |
|
1720 E Lake Bluff Blvd Shorewood WI 53211-1517 | |
| (414) 962-1800 | |
| (414) 962-2302 |
| Full Name | Lake Bluff Dental |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 1720 E Lake Bluff Blvd, Shorewood, Wisconsin |
| Authorized Official Name and Position | Carolyn Griffin (DENTIST) |
| Authorized Official Contact | 4149621800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Bluff Dental 4018 E Allerton Ave Cudahy WI 53110-1205 Ph: (262) 945-8227 | Lake Bluff Dental 1720 E Lake Bluff Blvd Shorewood WI 53211-1517 Ph: (414) 962-1800 |
| NPI Number | 1811426810 |
|---|---|
| Provider Enumeration Date | 06/05/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811426810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 7054-15 (Wisconsin) | Primary |
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