Individual
JACK MICHAEL KEESLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-5485
Mailing address
1571 WORTH AVE, NEENAH, WI 54956-5042
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
1001385-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2016
Last updated
09/06/2019
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