| Bailey A Youngblade, Llc | |
|
617 Ryan St Pewaukee WI 53072-1800 | |
| (262) 695-8600 | |
| Not Available |
| Full Name | Bailey A Youngblade, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 617 Ryan St, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Bailey Youngblade (OWNER) |
| Authorized Official Contact | 5153399655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bailey A Youngblade, Llc N53w16418 Whitetail Run Menomonee Falls WI 53051-0623 Ph: (515) 339-9655 | Bailey A Youngblade, Llc 617 Ryan St Pewaukee WI 53072-1800 Ph: (262) 695-8600 |
| NPI Number | 1720877897 |
|---|---|
| Provider Enumeration Date | 05/05/2025 |
| Last Update Date | 05/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720877897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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