Organization
LMG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY L MACKMAN (PRESIDENT/DIRECTOR)
(414) 476-9400
Entity
Organization
Contact information
Practice address
7001 S HOWELL AVE STE 800, OAK CREEK, WI 53154-1408
(414) 856-9990
Mailing address
2626 N 76TH ST STE 101, WAUWATOSA, WI 53213-1137
(414) 443-9283
(414) 771-7731
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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