Organization · Type 2 NPI

Familia Dental Racine LLC

Dental Clinic/Center · Racine, WI

NPI number 1962883926 Active

Practice location

5201 Washington Ave, Ste A
Racine, WI 53406-4242

Call (262) 634-0441 Map

Fax (262) 583-4198

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...

8 other providers at this address

Other dental clinic/center providers in Racine

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NPI record

NPI: 1962883926
Entity type: Organization (Type 2)
Issued: Jun 16, 2015
Last updated: Jun 25, 2021
Status: Active

Other names

<unavail>
Familia Dental · doing business as
Familia Dental · doing business as

Authorized official

Mr. Brandon Alexander Taylor, CPCS
Credentialing & Payer Relations Man
(847) 453-7396

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962883926

Familia Dental Racine LLC's National Provider Identifier is 1962883926, issued on Jun 16, 2015. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Racine, WI. The record was last updated on Jun 25, 2021.