Individual
DR. DAWN M LLORCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3528 MEACHEM RD, RACINE, WI 53405
(262) 598-8750
(262) 598-8769
Mailing address
3528 MEACHEM RD, RACINE, WI 53405
(262) 598-8750
(262) 598-8769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
08362
IA
1223G0001X
General Practice Dentistry
Primary
6075-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001774025
UNITED CONCORDIA
IA
05
—
0080200
—
IA
01
—
08362
BLUE DENTAL-BCBSIA
IA
01
—
1418752
IA CONTROLLED SUBSTANCE
IA
01
—
421060724
BILLING TAX ID# FOR CHC
IA
01
—
6075-015
WI STATE LICENSE #
WI
Enumeration date
06/02/2006
Last updated
03/07/2023
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