Individual
RAM RIZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
880 HERRIOTT DRIVE, MAUSTON, WI 53948
(920) 787-5514
(920) 787-4737
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6569-15
WI
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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