NPI 1134235427

Lmg, INC

Organisation Oral and Maxillofacial Pathology Dentistry Wauwatosa, WI

Practice location

Address: 2626 N 76th Street Suite 101, Wauwatosa, WI 53213-1137
Phone: (414) 476-9400
Fax: (414) 755-4769

Authorised official

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

Registered specialties

Oral and Maxillofacial Pathology Dentistry Primary

Dental Providers Taxonomy 1223P0106X

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Registry record

NPI: 1134235427
Entity type: Organization
NPI issued: 21 Aug 2006
Record last updated: 19 Jan 2017

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.