NPI 1003116765

Jay L. Mackman, DDS

Organisation General Practice Dentistry Wauwatosa, WI

Practice location

Address: 2626 N 76th St, Wauwatosa, WI 53213-1137
Phone: (414) 476-9400

Authorised official

Name: Karien Bakker
Title: Coo
Phone: (414) 774-7794

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X

Other Dentist providers in Wisconsin →

Registry record

NPI: 1003116765
Entity type: Organization
NPI issued: 28 Oct 2010
Record last updated: 28 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.