East Towne Dental Associated Belgium Family Dental Sc

NPI #1356489603 in Mequon, Wisconsin

Provider Information

NPI Number: 1356489603
Entity Type: Organization
Organization Name: East Towne Dental Associated Belgium Family Dental Sc
Primary Specialty: Dentist
Enumeration Date: Feb 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 11501 N PROT WASHINGTON RD
City: Mequon
State: Wisconsin
ZIP Code: 53092
Phone: (262) 241-8880

Authorized Official

Name: VALI KIAIE, DDS
Title: PRESIDENT
Phone: (262) 241-8880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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