Organization
THIRD COAST DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA EMMERICH DDS (OWNER/DENTIST)
(864) 359-0902
Entity
Organization
Contact information
Practice address
8531 W LINCOLN AVE, WEST ALLIS, WI 53227-2542
(414) 327-2700
Mailing address
8531 W LINCOLN AVE, WEST ALLIS, WI 53227-2542
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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