Individual
MICHELLE WANSERSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3460 N HUMBOLDT BLVD, MILWAUKEE, WI 53212-1702
(715) 581-2744
Mailing address
541 E ERIE ST UNIT 612, MILWAUKEE, WI 53202-6251
(715) 581-2744
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002254-15
WI
Other
Enumeration date
07/01/2019
Last updated
06/10/2020
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