Individual
MICHELLE NATALIE DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2555 N DR MARTIN LUTHER KING DR, MILWAUKEE HEALTH SERVICES INC, MILWAUKEE, WI 53212-2709
(414) 372-8080
(414) 760-3983
Mailing address
2555 N DR MARTIN LUTHER KING DR, MILWAUKEE HEALTH SERVICES INC, MILWAUKEE, WI 53212-2709
(414) 372-8080
(414) 760-3983
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4727
WI
1223D0001X
Public Health Dentistry
4727
WI
Other
Enumeration date
01/31/2007
Last updated
08/19/2013
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