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Individual

MARYAM TUNIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5623 N GREEN BAY AVE, GLENDALE, WI 53209-4406
(414) 228-3000
Mailing address
5623 N GREEN BAY AVE, GLENDALE, WI 53209-4406
(414) 202-0731

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001072-15
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114646072
NPI
Enumeration date
08/24/2022
Last updated
10/08/2023
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