| Familia Dental Mke Midtown Llc | |
|
5341 W Fond Du Lac Ave Milwakee WI 53216-1365 | |
| (414) 871-0827 | |
| (414) 871-0859 |
| Full Name | Familia Dental Mke Midtown Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5341 W Fond Du Lac Ave, Milwakee, Wisconsin |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING & PAYOR RELATIONS MAN) |
| Authorized Official Contact | 8474537393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental Mke Midtown Llc 2050 E Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Familia Dental Mke Midtown Llc 5341 W Fond Du Lac Ave Milwakee WI 53216-1365 Ph: (414) 871-0827 |
| NPI Number | 1083283626 |
|---|---|
| Provider Enumeration Date | 06/18/2021 |
| Last Update Date | 06/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083283626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |