Individual
DR. LAUREN JEAN BOSTANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
951 MAIN ST, UNION GROVE, WI 53182-1074
(262) 878-2422
Mailing address
23373 98TH ST, SALEM, WI 53168-8924
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002694
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2021
Last updated
08/27/2021
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