Organization
WEST ALLIS SMILES DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BUSHONG DDS (OWNER)
(715) 573-3546
Entity
Organization
Contact information
Practice address
5400 W LINCOLN AVE, MILWAUKEE, WI 53219-1662
(414) 327-6162
Mailing address
5400 W LINCOLN AVE, MILWAUKEE, WI 53219-1662
(414) 327-6162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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