| Northtown Dental Group S.c. | |
|
1929 W Atkinson Ave Milwaukee WI 53206-2452 | |
| (414) 442-4690 | |
| Not Available |
| Full Name | Northtown Dental Group S.c. |
|---|---|
| Speciality | Dentist |
| Location | 1929 W Atkinson Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | James W Mack (PRESIDENT) |
| Authorized Official Contact | 4144424690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northtown Dental Group S.c. 1929 W Atkinson Ave Milwaukee WI 53206-2452 Ph: (414) 442-4690 | Northtown Dental Group S.c. 1929 W Atkinson Ave Milwaukee WI 53206-2452 Ph: (414) 442-4690 |
| NPI Number | 1386877702 |
|---|---|
| Provider Enumeration Date | 09/02/2009 |
| Last Update Date | 09/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386877702 | NPI | - | NPPES |
| 333981000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5001475 (Wisconsin) | Primary |
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