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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