Individual
KEITH A STUMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3100 80TH ST, KENOSHA, WI 53142-4946
(262) 694-2961
(262) 942-7340
Mailing address
4467 114TH ST, PLEASANT PRAIRIE, WI 53158-3860
(262) 764-0368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3556015
WI
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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