Organization
KITTLESON & KITTLESON, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CLAYTON KITTLESON D.D.S. (PRESIDENT)
(414) 744-3500
Entity
Organization
Contact information
Practice address
3527 E SQUIRE AVE, CUDAHY, WI 53110-1426
(414) 744-3500
Mailing address
3527 E SQUIRE AVE, CUDAHY, WI 53110-1426
(414) 744-3500
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4648-015
WI
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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