Keystone South Milwaukee LLC
NPI #1114512225 in South Milwaukee, Wisconsin
Provider Information
- NPI Number
- 1114512225
- Entity Type
- Organization
- Organization Name
- Keystone South Milwaukee LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Mar 2, 2021
- Last Updated
- Mar 2, 2021
Practice Location
- Address
- 1113 COLLEGE AVE # B
- City
- South Milwaukee
- State
- Wisconsin
- ZIP Code
- 53172-1142
- Phone
- (414) 764-0212
Authorized Official
- Name
- MRS. TAMMY KEVIN
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (262) 873-0510
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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