| North Lake Family Dentistry | |
|
W315n7641 Hwy 83 Hartland WI 53029-9759 | |
| (262) 966-7668 | |
| Not Available |
| Full Name | North Lake Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | W315n7641 Hwy 83, Hartland, Wisconsin |
| Authorized Official Name and Position | Patty R Erickson (OWNER) |
| Authorized Official Contact | 2629667668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Lake Family Dentistry W315n7641 Hwy 83 Hartland WI 53029-9759 Ph: (262) 966-7668 | North Lake Family Dentistry W315n7641 Hwy 83 Hartland WI 53029-9759 Ph: (262) 966-7668 |
| NPI Number | 1366840456 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 12/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366840456 | NPI | - | NPPES |
| 1982723920 | Other | WI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6346 (Wisconsin) | Primary |
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