FAMILIA DENTAL RACINE LLC

RACINE, WI
NPI1962883926
Doing Business AsFAMILIA DENTAL
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 Date2015-06-16
Last Update Date2021-06-25
Business Address
FAMILIA DENTAL RACINE LLC
5201 WASHINGTON AVE STE A
RACINE, WI 53406-4242
Phone number: 262-634-0441
Mailing Address
FAMILIA DENTAL RACINE LLC
2050 EAST ALGONQUIN ROAD SUITE 610
SCHAUMBURG, IL 60173-4166
Phone number: 847-453-7396