Organization
NORTHSHORE SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BUSHONG (DENTIST, OWNER)
(715) 573-3546
Entity
Organization
Contact information
Practice address
10303 N PORT WASHINGTON RD STE 103A, MEQUON, WI 53092-5760
(262) 240-0405
Mailing address
10303 N PORT WASHINGTON RD STE 103A, MEQUON, WI 53092-5760
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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