The Kids Dentist Dental Center LLC

NPI #1922862473 in Mequon, Wisconsin

Provider Information

NPI Number: 1922862473
Entity Type: Organization
Organization Name: The Kids Dentist Dental Center LLC
Primary Specialty: Dentist
Enumeration Date: Feb 6, 2024
Last Updated: Feb 6, 2024

Practice Location

Address: 10618 N PORT WASHINGTON RD
City: Mequon
State: Wisconsin
ZIP Code: 53092-5013
Phone: (262) 249-6419

Authorized Official

Name: MICHAEL COLE
Title: SVP INSURANCE PLAN MANAGEMENT
Phone: (727) 424-2990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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