MEDICARE: FRESH COAST 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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1780393728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESH COAST DENTAL LLC

Provider Business Mailing Address
First Line	:	6790 W LAYTON AVE STE C
Second Line	:
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4571
Country	:	US
Telephone Number	:	414-687-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	6790 W LAYTON AVE STE C
Second Line	:
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4571
Country	:	US
Telephone Number	:	414-687-9831
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	AHMED ALSALLAMI
Credential	:	DDS
Telephone Number	:	414-687-9831

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	11/17/2022

Similar Medicare Providers

1083610604 — MR. BRIAN SCOTT KELSEY C.P.O.
Practice Location Address:

6790 WEST LAYTON AVENUE
GREENFIELD, WI
53220-4571

Practice Phone: 414-282-3100
Practice Fax: 414-282-3101

1629367339 — REICHERT & KELSEY PROSTHETICS ORTHOTICS, LLC
Practice Location Address:

6790 W LAYTON AVE
GREENFIELD, WI
53220-4571

Practice Phone: 414-282-3100
Practice Fax: 414-282-3101

1164796496 — KELSEY PROSTHETICS ORTHOTICS LLC
Practice Location Address:

6790 W LAYTON AVE
GREENFIELD, WI
53220-4571

Practice Phone: 414-282-3100
Practice Fax: 414-282-3101

1922790674 — DR. TUSHAR CHIMANBHAI THUMMAR DMD
Practice Location Address:

6790 W LAYTON AVE STE C
GREENFIELD, WI
53220-4571

Practice Phone: 414-285-7929
Practice Fax:

1205632379 — KELSEY PROSTHETICS ORTHOTICS LLC
Practice Location Address:

6790 W LAYTON AVE
GREENFIELD, WI
53220-4571

Practice Phone: 414-282-3100
Practice Fax: 414-282-3101

1720646193 — DR. COLIN LEE OD
Practice Location Address:

4300 W LAYTON AVE STE 100
GREENFIELD, WI
53220-4136

Practice Phone: 414-928-2020
Practice Fax: 414-210-3402

Directions to “FRESH COAST DENTAL LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.