Individual
DR. INNA KOTLYARENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10425 W NORTH AVE, SUITE 335, WAUWATOSA, WI 53226
(414) 476-3909
Mailing address
10425 W NORTH AVE, SUITE 335, WAUWATOSA, WI 53226
(414) 476-3909
(414) 476-3909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3358
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33468300
—
WI
Enumeration date
06/06/2007
Last updated
07/08/2007
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