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Organization
MIER DENTAL ASSOCIATES LLC
Active
Organization
MIER DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA GONZALEZ (PRESIDENT)
(949) 335-8569
Entity
Organization
Contact information
Practice address
3216 S 92ND ST STE 104, MILWAUKEE, WI 53227-4577
(414) 885-6140
Mailing address
3216 S 92ND ST STE 104, MILWAUKEE, WI 53227-4577
(414) 885-6140
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
03/30/2021
Last updated
04/09/2021
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