My Smile- West Allis LLC
NPI #1871299818 in West Allis, Wisconsin
Provider Information
- NPI Number
- 1871299818
- Entity Type
- Organization
- Organization Name
- My Smile- West Allis LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 1, 2023
- Last Updated
- Feb 1, 2023
Practice Location
- Address
- 2572 S 76TH ST
- City
- West Allis
- State
- Wisconsin
- ZIP Code
- 53219-2476
- Phone
- (414) 321-7700
Authorized Official
- Name
- DR. HIDAYATHULLA KHAN
- Title
- OWNER
- Phone
- (414) 321-7700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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