Machi, Grace Lucretia

Machi, Grace Lucretia is an sole proprietor health care provider with primary practice located at 20611 Watertown Rd Suite K, Waukesha WI 53186-1871. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Machi, Grace Lucretia can be contacted via phone (262) 798-9800.

Contact Information

Primary practice address
20611 Watertown Rd Suite K Waukesha WI 53186-1871
Fax: (262) 798-9827
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 5001866-015 Wisconsin

Profile Details

NPI number 1215084835
LBN Legal business name Machi, Grace Lucretia
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215084835 NPPES
Wisconsin MEDICAID 33421700

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