Organization
MAJOR DENTAL CLINICS OF MILWAUKEE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL DOMAGALA D.D.S.,M.S. (PRESIDENT)
(414) 276-4262
Entity
Organization
Contact information
Practice address
788 N JEFFERSON ST, SUITE 880, MILWAUKEE, WI 53202-3718
(414) 276-4262
(414) 276-4269
Mailing address
788 N JEFFERSON ST, SUITE 880, MILWAUKEE, WI 53202-3718
(414) 276-4262
(414) 276-4269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6468
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6468
LICENSE
WI
Enumeration date
07/14/2016
Last updated
07/14/2016
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