Organization · Type 2 NPI
Familia Dental Kenosha LLC
Dental Clinic/Center · Kenosha, WI
NPI number
1154782209
Active
Practice location
6430 Green Bay Rd., Ste. 112
Kenosha, WI 53142-2948
Fax (262) 455-7710
Mailing address
2050 East Algonquin Road, Suite 610
Schaumburg, IL 60173-4166
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | None listed |
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1154782209
Familia Dental Kenosha LLC's National Provider Identifier is 1154782209, issued on Mar 17, 2016. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Kenosha, WI. The record was last updated on Jun 25, 2021.