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NPI 1205624061

NPI 1205624061 : 15 ASRA DENTAL LLC : MILWAUKEE, WI

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General NPI Number Information
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    NPI Number           |    1205624061
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    Entity Type          |    Organization 
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    Legal Business Name  |    15 ASRA DENTAL LLC 
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Dates
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    Enumeration Date     |    04/30/2025
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    Last Update Date     |    04/30/2025
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Provider Practice Location Address
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    Address Line         |    1502 S LAYTON BLVD 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53215-1925
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    Country              |    US
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    Telephone            |    414-246-7024
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    Fax                  |    414-600-5554
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Provider Business Mailing Address
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    Address Line         |    1502 S LAYTON BLVD 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53215-1925
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    Country              |    US
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    Telephone            |    414-246-7024
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    Fax                  |    414-600-5554
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. RAMAN PREET  KAUR 
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    Credential           |    DDS
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    Telephone            |    414-246-7024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    
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    License Number State |    
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