Ltc Dental Iii Llc | |
1314 S 1st St # 276 Milwaukee WI 53204-2405 | |
(888) 970-3400 | |
(888) 456-3812 |
Full Name | Ltc Dental Iii Llc |
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Speciality | Dentist - General Practice |
Location | 1314 S 1st St # 276, Milwaukee, Wisconsin |
Authorized Official Name and Position | Tara Robinson (OWNER) |
Authorized Official Contact | 4073753003 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ltc Dental Iii Llc 2314 S Route 59 Ste 384 Plainfield IL 60586-7756 Ph: (888) 970-3400 | Ltc Dental Iii Llc 1314 S 1st St # 276 Milwaukee WI 53204-2405 Ph: (888) 970-3400 |
NPI Number | 1467169409 |
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Provider Enumeration Date | 10/31/2022 |
Last Update Date | 04/06/2023 |
Identifier | Type | State | Issuer |
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1467169409 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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