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Organization
KEYSTONE SOUTH MILWAUKEE LLC
Active
Organization
KEYSTONE SOUTH MILWAUKEE LLC
Active
Other names
South Milwaukee Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY KEVIN (DIRECTOR OF OPERATIONS)
(262) 873-0510
Entity
Organization
Contact information
Practice address
1113 COLLEGE AVE # B, SOUTH MILWAUKEE, WI 53172-1142
(414) 764-0212
Mailing address
PO BOX 180163, DELAFIELD, WI 53018-0163
(262) 873-0510
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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