| My Smile- West Allis Llc | |
|
2572 S 76th St West Allis WI 53219-2476 | |
| (414) 321-7700 | |
| Not Available |
| Full Name | My Smile- West Allis Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2572 S 76th St, West Allis, Wisconsin |
| Authorized Official Name and Position | Hidayathulla Khan (OWNER) |
| Authorized Official Contact | 4143217700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Smile- West Allis Llc 2572 S 76th St West Allis WI 53219-2476 Ph: (414) 321-7700 | My Smile- West Allis Llc 2572 S 76th St West Allis WI 53219-2476 Ph: (414) 321-7700 |
| NPI Number | 1871299818 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871299818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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