Organization
THE KIDS DENTIST DENTAL CENTER LLC
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COLE (SVP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
10618 N PORT WASHINGTON RD, MEQUON, WI 53092-5013
(262) 249-6419
Mailing address
10618 N PORT WASHINGTON RD, MEQUON, WI 53092-5013
(262) 249-6419
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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