| Mitchell Street Dental | |
|
710 W. Historic Mitchell St. Mitchell Street Dental Milwaukee WI 53204 | |
| (414) 383-2426 | |
| (414) 383-2254 |
| Full Name | Mitchell Street Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 710 W. Historic Mitchell St., Milwaukee, Wisconsin |
| Authorized Official Name and Position | Tony H. Yong (PRESIDENT/OWNER) |
| Authorized Official Contact | 4143832426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mitchell Street Dental 710 W. Historic Mitchell St. Mitchell Street Dental Milwaukee WI 53204 Ph: (414) 383-2426 | Mitchell Street Dental 710 W. Historic Mitchell St. Mitchell Street Dental Milwaukee WI 53204 Ph: (414) 383-2426 |
| NPI Number | 1174850499 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 11/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174850499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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