Individual
MARK RICHARD WITTCHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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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