Individual
MRS. VIJAYATA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
15100 W. LIBRARY LN., NEW BERLIN, WI 53151
(262) 641-0056
(262) 641-0058
Mailing address
15100 W. LIBRARY LN., NEW BERLIN, WI 53151
(262) 641-0056
(262) 641-0058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901020281
MI
Other
Enumeration date
08/12/2010
Last updated
02/04/2016
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