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NPI Code Detail

MEDICARE: TOSA DENTAL LLC

MEDICARE: TOSA DENTAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6533-15WI

General Provider Information

NPI Number : 1649643222
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOSA DENTAL LLC
Provider Business Mailing Address
First Line : 8715 W NORTH AVE
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-2723
Country : US
Telephone Number : 414-258-5660
Fax Number : 414-258-5336
Provider Business Practice Location Address
First Line : 8715 W NORTH AVE
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-2723
Country : US
Telephone Number : 414-258-5660
Fax Number : 414-258-5336
Authorized Official
Title or Position : OWNER
Name : DR. ANNE ALLMANN
Credential : DDS
Telephone Number : 414-258-5660
Provider Enumeration Date : 11/04/2015
Last Update Date : 11/04/2015

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Directions to “TOSA DENTAL LLC ” Practice Location

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