NPI 1184793580

Generations Family Dental

Organisation General Practice Dentistry Wauwatosa, WI

Practice location

Address: 2505 N Mayfair Rd #103, Wauwatosa, WI 53226
Phone: (414) 258-2117
Fax: (414) 258-4177

Authorised official

Name: Fred a Lacourt
Title: Dentist
Phone: (414) 258-2117

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 3547WI (WI)

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Registry record

NPI: 1184793580
Entity type: Organization
NPI issued: 7 Nov 2006
Record last updated: 22 Jun 2015

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.