Individual
MARK RICHARD WITTCHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6001325
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DDS-09955
IA
Other
Enumeration date
03/31/2019
Last updated
09/15/2023
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