Organization
J.L. MACKMAN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY L MACKMAN (DENTIST)
(414) 476-9400
Entity
Organization
Contact information
Practice address
2626 N WAUWATOSA AVE, WAUWATOSA, WI 53213-1137
(414) 476-9400
(414) 962-9599
Mailing address
2626 N WAUWATOSA AVE, WAUWATOSA, WI 53213-1137
(414) 476-9400
(414) 962-9599
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2793
WI
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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