| Park Family Dental Llc | |
|
1001 Madison Ave South Milwaukee WI 53172-2500 | |
| (414) 203-9664 | |
| Not Available |
| Full Name | Park Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1001 Madison Ave, South Milwaukee, Wisconsin |
| Authorized Official Name and Position | Joon Jae Park (OWNER) |
| Authorized Official Contact | 2627204669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Family Dental Llc W201n5244 Sandpiper Ln Menomonee Falls WI 53051-6209 Ph: (262) 720-4669 | Park Family Dental Llc 1001 Madison Ave South Milwaukee WI 53172-2500 Ph: (414) 203-9664 |
| NPI Number | 1720791817 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 01/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720791817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Bright Smiles Family Dentsitry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Milwaukee Ave, South Milwaukee, WI 53172 Phone: 414-762-2300 | |
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