Organization
LAKESHORE FAMILY DENTAL CENTER FOX POINT LLC
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
6878 N SANTA MONICA BLVD, FOX POINT, WI 53217-3965
(414) 247-1990
Mailing address
6878 N SANTA MONICA BLVD, FOX POINT, WI 53217-3965
(414) 247-1990
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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