| Restoration Dental Llc | |
|
6373 N Jean Nicolet Rd Ste 202 Glendale WI 53217-4184 | |
| (414) 228-9680 | |
| Not Available |
| Full Name | Restoration Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6373 N Jean Nicolet Rd Ste 202, Glendale, Wisconsin |
| Authorized Official Name and Position | Bridget Mackey (OWNER) |
| Authorized Official Contact | 4147328043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Dental Llc 6373 N Jean Nicolet Rd Ste 202 Glendale WI 53217-4184 Ph: (414) 228-9680 | Restoration Dental Llc 6373 N Jean Nicolet Rd Ste 202 Glendale WI 53217-4184 Ph: (414) 228-9680 |
| NPI Number | 1487211447 |
|---|---|
| Provider Enumeration Date | 05/24/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487211447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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