| Wisconsin Smiles | |
|
6719 W Capitol Dr Milwaukee WI 53216-2041 | |
| (414) 464-6300 | |
| (414) 464-2874 |
| Full Name | Wisconsin Smiles |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6719 W Capitol Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Hidayathulla Khan (PRESIDENT) |
| Authorized Official Contact | 2247669876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Smiles 6719 W Capitol Dr Milwaukee WI 53216-2041 Ph: (414) 464-6300 | Wisconsin Smiles 6719 W Capitol Dr Milwaukee WI 53216-2041 Ph: (414) 464-6300 |
| NPI Number | 1467059865 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 10/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467059865 | NPI | - | NPPES |
| 1699128082 | Other | CMS-NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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