Individual
DR. THOMAS J KVANBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16 E BAYFIELD ST, 16 E BAYFIELD ST, WASHBURN, WI 54891-4401
(715) 373-2612
Mailing address
PO BOX 265, 16 E BAYFIELD ST., WASHBURN, WI 54891-0265
(715) 373-2612
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2784
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33427800
—
WI
Enumeration date
02/28/2007
Last updated
07/09/2007
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