Organization
BAY VIEW DENTAL CARE, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS PERSICH DDS (PARTNER)
(414) 482-2090
Entity
Organization
Contact information
Practice address
3380 S KINNICKINNIC AVE, MILWAUKEE, WI 53207-3159
(414) 482-2090
Mailing address
3380 S KINNICKINNIC AVE, MILWAUKEE, WI 53207-3159
(414) 482-2090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001644
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38364400
—
WI
Enumeration date
10/26/2006
Last updated
08/22/2020
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