Ltc Dental II LLC
NPI #1780341099 in Saint Francis, Wisconsin
Provider Information
- NPI Number
- 1780341099
- Entity Type
- Organization
- Organization Name
- Ltc Dental II LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Nov 22, 2021
- Last Updated
- Nov 22, 2021
Practice Location
- Address
- 4060 S LAKE DR APT 4
- City
- Saint Francis
- State
- Wisconsin
- ZIP Code
- 53235-5256
- Phone
- (407) 375-3003
Authorized Official
- Name
- TARA ROBINSON
- Title
- CHIEF EXECUTE OFFICER
- Phone
- (407) 375-3003
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Hygienist |
| Dentist |
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