Organization
STEPHEN R. VAN ESS, D.D.S., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN REYNOLDS VAN ESS DDS (PRESIDENT)
(262) 626-8444
Entity
Organization
Contact information
Practice address
1053 FOND DU LAC AVE, KEWASKUM, WI 53040-9495
(262) 626-8444
Mailing address
1053 FOND DU LAC AVE, P.O. BOX 559, KEWASKUM, WI 53040-9495
(262) 626-8444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
02775
WI
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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