Organization
RESTORATION DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET MACKEY DDS (OWNER)
(414) 732-8043
Entity
Organization
Contact information
Practice address
6373 N JEAN NICOLET RD STE 202, GLENDALE, WI 53217-4184
(414) 228-9680
Mailing address
6373 N JEAN NICOLET RD STE 202, GLENDALE, WI 53217-4184
(414) 228-9680
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2019
Last updated
06/11/2019
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