| Ltc Dental | |
|
4060 S Lake Dr Apt 4 Saint Francis WI 53235-5256 | |
| (407) 375-3003 | |
| (800) 863-5373 |
| Full Name | Ltc Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4060 S Lake Dr Apt 4, Saint Francis, 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 |
|---|---|
| Ltc Dental 4060 S Lake Dr Apt 4 Saint Francis WI 53235-5256 Ph: (407) 375-3003 | Ltc Dental 4060 S Lake Dr Apt 4 Saint Francis WI 53235-5256 Ph: (407) 375-3003 |
| NPI Number | 1124619556 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 01/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124619556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Ltc Dental Ii Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4060 S Lake Dr Apt 4, Saint Francis, WI 53235 Phone: 407-375-3003 Fax: 800-863-5373 |