NPI 1063951663

Lmg INC

Organisation Oral and Maxillofacial Pathology Dentistry Appleton, WI

Practice location

Address: W3134 van Roy Rd, Appleton, WI 54915-3982
Phone: (920) 882-1710
Fax: (920) 882-1708
Mailing address: 2626 N 76th St Suite 105, Wauwatosa, WI 53213-1137

Authorised official

Name: Jay L Mackman
Title: Owner-Director
Phone: (414) 476-9400

Registered specialties

Oral and Maxillofacial Pathology Dentistry Primary

Dental Providers Taxonomy 1223P0106X

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Registry record

NPI: 1063951663
Entity type: Organization
NPI issued: 15 Feb 2017
Record last updated: 28 Aug 2023

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.