Full Name | Lmg Inc |
---|---|
Speciality | Dentist - Oral And Maxillofacial Pathology |
Location | W3134 Van Roy Rd, Appleton, Wisconsin |
Authorized Official Name and Position | Jay L Mackman (OWNER-DIRECTOR) |
Authorized Official Contact | 4144769400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lmg Inc 2626 N 76th St Suite 105 Wauwatosa WI 53213-1137 Ph: (414) 476-9400 | Lmg Inc W3134 Van Roy Rd Appleton WI 54915-3982 Ph: (920) 882-1710 |
NPI Number | 1063951663 |
---|---|
Provider Enumeration Date | 02/15/2017 |
Last Update Date | 08/28/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063951663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
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