Organization
LTC DENTAL III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA ROBINSON (OWNER)
(407) 375-3003
Entity
Organization
Contact information
Practice address
1314 S 1ST ST # 276, MILWAUKEE, WI 53204-2405
(888) 970-3400
(888) 456-3812
Mailing address
2314 S ROUTE 59 STE 384, PLAINFIELD, IL 60586-7756
(888) 970-3400
(888) 456-3812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
04/06/2023
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