Organization
IDA MED LLC
Active
Parent organization
EXCEL DENTAL
Other names
Excel Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXCEL DENTAL
Authorized official
MAHMOUD ALSHARKAWI (OWNER)
(414) 334-1080
Entity
Organization
Contact information
Practice address
800 W LAYTON AVE, MILWAUKEE, WI 53221-2427
(414) 334-1080
Mailing address
800 W LAYTON AVE, MILWAUKEE, WI 53221-2427
(414) 334-1080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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