Organization
FRESH COAST DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED ALSALLAMI DDS (OWNER/DENTIST)
(414) 687-9831
Entity
Organization
Contact information
Practice address
6790 W LAYTON AVE STE C, GREENFIELD, WI 53220-4571
(414) 687-9831
Mailing address
6790 W LAYTON AVE STE C, GREENFIELD, WI 53220-4571
(414) 687-9831
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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