| Lmg Inc | |
|
2727 N Grandview Blvd Suite 100 Waukesha WI 53188-6100 | |
| (262) 547-9422 | |
| (262) 548-0644 |
| Full Name | Lmg Inc |
|---|---|
| Speciality | Dentist |
| Location | 2727 N Grandview Blvd, Waukesha, Wisconsin |
| Authorized Official Name and Position | Jay L Mackman (OWNER-DIRECTOR) |
| Authorized Official Contact | 4144769400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lmg Inc 2626 N 76th St Suite 105 Wauwatosa WI 53213-1137 Ph: (414) 476-9400 | Lmg Inc 2727 N Grandview Blvd Suite 100 Waukesha WI 53188-6100 Ph: (262) 547-9422 |
| NPI Number | 1790224491 |
|---|---|
| Provider Enumeration Date | 02/15/2017 |
| Last Update Date | 02/15/2017 |
| Medicare PECOS PAC ID | 6305851676 |
|---|---|
| Medicare Enrollment ID | O20170217000543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790224491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
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