| Dr Randall J Mcdaniel, DMD | |
|
2626 N 76th St, Wauwatosa, WI 53213 | |
| (414) 476-9400 | |
| Not Available |
| Full Name | Dr Randall J Mcdaniel |
|---|---|
| Gender | Male |
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 2626 N 76th St, Wauwatosa, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518063874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 5934-015 (Wisconsin) | Primary |
| Entity Name | Lmg Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134235427 PECOS PAC ID: 6305851676 Enrollment ID: O20060208000608 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randall J Mcdaniel, DMD 2626 N 76th St, Wauwatosa, WI 53213 Ph: (414) 476-9400 | Dr Randall J Mcdaniel, DMD 2626 N 76th St, Wauwatosa, WI 53213 Ph: (414) 476-9400 |
Dr. Julia Elizabeth Kennedy, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 11819 W Diane Dr, Wauwatosa, WI 53226 Phone: 262-894-6230 | |
Kenneth Paul Ferentchak, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1011 N Mayfair Rd, Suite 303, Wauwatosa, WI 53226 Phone: 414-771-4480 Fax: 414-771-8862 | |
Dr. Christopher N. Jordan, D.D.S., M.S.D., P.C. Dentist Medicare: Not Enrolled in Medicare Practice Location: 11711 W Burleigh St, Wauwatosa, WI 53222 Phone: 414-771-2345 Fax: 414-777-3839 | |
Dr. David Robert Laste, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 11637 W North Ave, Wauwatosa, WI 53226 Phone: 414-259-0665 Fax: 414-259-1057 | |
Dr. Richard V. Knoff, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2600 N Mayfair Rd, Suite 505, Wauwatosa, WI 53226 Phone: 414-258-1500 | |
Robert Walker Mier, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2626 N 76th St, Suite 105, Wauwatosa, WI 53213 Phone: 414-476-9400 Fax: 414-755-4769 | |
Dr. Dennis Moore Robbins, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 11711 W Burleigh St, Wauwatosa, WI 53222 Phone: 414-777-3801 |