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General NPI Number Information
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NPI Number | 1841988565
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Entity Type | Organization
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Legal Business Name | AWS DENTAL, LLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 11345 N PORT WASHINGTON RD FL 1
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City | MEQUON
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State | WI
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Zip | 53092-3411
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Country | US
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Telephone | 262-241-4440
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Fax |
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Provider Business Mailing Address
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Address Line | N66W4905 CEDAR RESERVE CIR
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City | CEDARBURG
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State | WI
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Zip | 53012-3509
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Country | US
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Telephone | 859-913-5706
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDER WILLIAM SILVIA
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Credential | DMD
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Telephone | 859-913-5706
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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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