Organization
LMG, INC
Active
Other names
TMJ & Orofacial Pain Treatment Centers of WI
Organization subpart
No
Provider details
NPI number
Authorized official
JAY L MACKMAN D.D.S. (OWNER-PRESIDENT)
(414) 476-9400
Entity
Organization
Contact information
Practice address
2626 N 76TH STREET, SUITE 101, WAUWATOSA, WI 53213-1137
(414) 476-9400
(414) 755-4769
Mailing address
2626 N 76TH STREET, SUITE 101, WAUWATOSA, WI 53213-1137
(414) 476-9400
(414) 755-4769
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
WI
Other
Enumeration date
08/21/2006
Last updated
01/19/2017
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