Individual
DR. LAURA M TILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
604 RIVER PLACE DR, MONONA, WI 53716
(608) 222-9142
(608) 226-8818
Mailing address
604 RIVER PLACE DR, MONONA, WI 53716
(608) 222-9142
(608) 226-8818
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5694015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33795300
—
WI
Enumeration date
11/27/2006
Last updated
07/08/2007
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