FAMILIA DENTAL KENOSHA LLC

KENOSHA, WI
NPI1154782209
Entity TypeOrganization
Authorized ContactBRANDON ALEXANDER TAYLOR
Credentialing & Payer Relations Man
847-453-7396
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Additional Taxonomies1223G0001X Dentist, General Practice
Enumeration Date2016-03-17
Last Update Date2021-06-25
Business Address
FAMILIA DENTAL KENOSHA LLC
6430 GREEN BAY RD. STE. 112
KENOSHA, WI 53142-2948
Phone number: 262-653-3980
Mailing Address
FAMILIA DENTAL KENOSHA LLC
2050 EAST ALGONQUIN ROAD SUITE 610
SCHAUMBURG, IL 60173-4166
Phone number: 847-453-7396