Individual
DR. JOHN C. KITTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10521 N PORT WASHINGTON RD, MEQUON, WI 53092-5584
(262) 241-3141
Mailing address
10521 N PORT WASHINGTON RD, MEQUON, WI 53092-5584
(262) 241-3141
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4648-015
WI
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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