Wisconsin Smiles

NPI #1457905861 in Racine, Wisconsin

Provider Information

NPI Number
1457905861
Entity Type
Organization
Organization Name
Wisconsin Smiles
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jul 25, 2019
Last Updated
Jul 25, 2019

Practice Location

Address
4915 WASHINGTON AVE STE B
City
Racine
ZIP Code
53406-4249
Phone
(262) 619-1949

Authorized Official

Name
HIDAYATHULLA SMILE KHAN, DMD
Title
OWNER
Phone
(224) 443-4988

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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