Fresh Coast Dental LLC
NPI #1780393728 in Greenfield, Wisconsin
Provider Information
- NPI Number
- 1780393728
- Entity Type
- Organization
- Organization Name
- Fresh Coast Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 17, 2022
- Last Updated
- Nov 17, 2022
Practice Location
- Address
- 6790 W LAYTON AVE STE C
- City
- Greenfield
- State
- Wisconsin
- ZIP Code
- 53220-4571
- Phone
- (414) 687-9831
Authorized Official
- Name
- AHMED ALSALLAMI, DDS
- Title
- OWNER/DENTIST
- Phone
- (414) 687-9831
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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