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Organization

MAYFAIF FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAKISHA ARIF-HOLMES (DENTIST/OWNER)
(414) 259-0665
Entity
Organization

Contact information

Practice address
11637 W NORTH AVE, WAUWATOSA, WI 53226-2129
(414) 259-0665
Mailing address
11637 W NORTH AVE, WAUWATOSA, WI 53226-2129

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6448-15
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982867024
WI
Enumeration date
08/05/2017
Last updated
08/05/2017
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