Family Dental of South East Wisconsin, S.c.

NPI #1053312389 in West Allis, Wisconsin

Provider Information

NPI Number: 1053312389
Entity Type: Organization
Organization Name: Family Dental of South East Wisconsin, S.c.
Primary Specialty: Dentist
Enumeration Date: Aug 9, 2005
Last Updated: Oct 23, 2019

Practice Location

Address: 10202 W HAYES AVE
City: West Allis
State: Wisconsin
ZIP Code: 53227-2042
Phone: (414) 321-2720

Authorized Official

Name: DR. THOMAS P CASEY, DDS
Title: EMPLOYEE
Phone: (414) 321-2720

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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