Jay L. Mackman, DDS

NPI #1003116765 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1003116765
Entity Type: Organization
Organization Name: Jay L. Mackman, DDS
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 28, 2010
Last Updated: Oct 28, 2010

Practice Location

Address: 2626 N 76TH ST
City: Wauwatosa
State: Wisconsin
ZIP Code: 53213-1137
Phone: (414) 476-9400

Authorized Official

Name: KARIEN BAKKER
Title: COO
Phone: (414) 774-7794

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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