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Organization
HIGHLAND PARK FAMILY DENTISTRY, SC
Active
Organization
HIGHLAND PARK FAMILY DENTISTRY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN ANN GORMAN DDS (OWNER)
(414) 475-9035
Entity
Organization
Contact information
Practice address
6101 W VLIET ST, WAUWATOSA, WI 53213-2485
(414) 475-9035
(414) 475-9039
Mailing address
6101 W VLIET ST, WAUWATOSA, WI 53213-2485
(414) 475-9035
(414) 475-9039
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4097
WI
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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