| Lakeshore Family Dental Center Greendale Llc | |
|
5808 Broad St Greendale WI 53129-2404 | |
| (414) 421-2303 | |
| Not Available |
| Full Name | Lakeshore Family Dental Center Greendale Llc |
|---|---|
| Speciality | Dentist |
| Location | 5808 Broad St, Greendale, Wisconsin |
| Authorized Official Name and Position | Mike Cole (VP INSURANCE PLAN MANAGEMENT) |
| Authorized Official Contact | 7274242990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Family Dental Center Greendale Llc 5808 Broad St Greendale WI 53129-2404 Ph: (414) 421-2303 | Lakeshore Family Dental Center Greendale Llc 5808 Broad St Greendale WI 53129-2404 Ph: (414) 421-2303 |
| NPI Number | 1932982113 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932982113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Greendale Dental Associates, S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5808 Broad St, Greendale, WI 53129 Phone: 414-421-2303 Fax: 414-421-2576 |