Familia Dental Mke Midtown LLC

NPI #1083283626 in Milwakee, Wisconsin

Provider Information

NPI Number
1083283626
Entity Type
Organization
Organization Name
Familia Dental Mke Midtown LLC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jun 18, 2021
Last Updated
Jun 18, 2021

Practice Location

Address
5341 W FOND DU LAC AVE
ZIP Code
53216-1365
Phone
(414) 871-0827

Authorized Official

Name
MR. BRANDON ALEXANDER TAYLOR, CPCS
Title
CREDENTIALING & PAYOR RELATIONS MAN
Phone
(847) 453-7393

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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