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Individual

DR. DAVID MICHAEL CONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
(262) 764-3636
Mailing address
625 57TH ST, SUITE 700, KENOSHA, WI 53140-4146
(262) 764-3622
(262) 764-3636

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6511
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245469253
WI
Enumeration date
07/11/2009
Last updated
11/12/2014
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