| Diamond Dental LLC | |
|
1520 S 108th St West Allis WI 53214-4019 | |
| (414) 400-3343 | |
| Not Available |
| Full Name | Diamond Dental LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1520 S 108th St, West Allis, Wisconsin |
| Authorized Official Name and Position | Camille Simper (MANAGER) |
| Authorized Official Contact | 4144003343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Dental LLC 5542 W Fond Du Lac Ave Milwaukee WI 53216-1200 | Diamond Dental LLC 1520 S 108th St West Allis WI 53214-4019 Ph: (414) 400-3343 |
| NPI Number | 1558121590 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 03/19/2024 |
| Certification Date | 03/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558121590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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