Layton Dental Lab

NPI #1740628254 in Pewaukee, Wisconsin

Provider Information

NPI Number: 1740628254
Entity Type: Organization
Organization Name: Layton Dental Lab
Primary Specialty: Dental Laboratory
Enumeration Date: Jun 6, 2013
Last Updated: Jun 6, 2013

Practice Location

Address: 495 HICKORY ST
City: Pewaukee
State: Wisconsin
ZIP Code: 53072-3537
Phone: (262) 691-7100

Authorized Official

Name: MR. RICHARD BONG
Title: PRESIDENT
Phone: (262) 691-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Laboratory	292200000X	Primary

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