Individual
ALIA MENTINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
932 S 60TH ST STE 201, WEST ALLIS, WI 53214-3369
(414) 323-2057
(414) 323-2067
Mailing address
932 S 60TH ST STE 201, WEST ALLIS, WI 53214-3369
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001789
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/05/2025
Last updated
01/28/2026
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