Organization
KEYSTONE WEST ALLIS LLC WEST ALLIS DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY KEVIN (OPERATIONS MANAGER)
(262) 873-0510
Entity
Organization
Contact information
Practice address
7130 W GREENFIELD AVE, WEST ALLIS, WI 53214-4708
(414) 258-2500
Mailing address
PO BOX 180163, DELAFIELD, WI 53018-0163
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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