North Lake Family Dentistry

NPI 1366840456 - Clinic/Center - 261QD0000X

NPI Details
NPI 1366840456
Enumeration Date 12/05/2014
Last Updated 12/05/2014
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name PATTY R PATTY
Position OWNER
Phone (262) 966-7668
Fax
Practice Location
W315N7641 HWY 83
HARTLAND WI, 53029-9759, US
Phone (262) 966-7668
Fax
Business Location
W315N7641 HWY 83
HARTLAND WI, 53029-9759, US
Phone (262) 966-7668
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State Wisconsin
License Number 6346
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According to our database, North Lake Family Dentistry NPI is 1366840456, taxonomy code is 261QD0000X and license number is 6346, license state is located at Wisconsin. North Lake Family Dentistry physically located at W315n7641 Hwy 83, Hartland WI, 53029-9759. NPI Number 1033115704 has the healthcare provider type.

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1366840456 NPI number is provided on an as is basis without warranty of any kind. 1366840456 is maintained by the National Plan & Provider Enumeration System. The contents of North Lake Family Dentistry are for informational purposes only.