Organization
ORTHO 360 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVANA BUENO (DIRECTOR)
(773) 798-9382
Entity
Organization
Contact information
Practice address
10809 W LINCOLN AVE, MILWAUKEE, WI 53227-1177
(877) 795-0360
Mailing address
10809 W LINCOLN AVE, MILWAUKEE, WI 53227-1177
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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