| Smile FX | |
|
6919 W. Forest Home Ave. Milwaukee WI 53220 | |
| (414) 545-8226 | |
| (414) 543-4805 |
| Full Name | Smile FX |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6919 W. Forest Home Ave., Milwaukee, Wisconsin |
| Authorized Official Name and Position | Glenn Gequillana (DENTIST/OWNER) |
| Authorized Official Contact | 4145458226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile FX 6919 W. Forest Home Ave. Milwaukee WI 53220 Ph: (414) 545-8226 | Smile FX 6919 W. Forest Home Ave. Milwaukee WI 53220 Ph: (414) 545-8226 |
| NPI Number | 1356096507 |
|---|---|
| Provider Enumeration Date | 02/16/2022 |
| Last Update Date | 02/16/2022 |
| Certification Date | 02/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356096507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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