Generations Family Dental

NPI #1184793580 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1184793580
Entity Type: Organization
Organization Name: Generations Family Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 7, 2006
Last Updated: Jun 22, 2015

Practice Location

Address: 2505 N MAYFAIR RD
Address 2: #103
City: Wauwatosa
State: Wisconsin
ZIP Code: 53226
Phone: (414) 258-2117

Authorized Official

Name: DR. FRED A LACOURT, DDS
Title: DENTIST
Phone: (414) 258-2117

Specialties & Taxonomy Codes

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

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