Organization
HIGHLAND PARK FAMILY DENTISTRY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN ANN GORMAN DDS (OWNER)
(414) 475-9035
Entity
Organization
Contact information
Practice address
6101 W VLIET ST, WAUWATOSA, WI 53213-2485
(414) 475-9035
(414) 475-9039
Mailing address
6101 W VLIET ST, WAUWATOSA, WI 53213-2485
(414) 475-9035
(414) 475-9039
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4097
WI
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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