Individual
RYAN MICHAEL STUKENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1125 STEPHENSON LN, WAUNAKEE, WI 53597-2516
(608) 849-4424
Mailing address
2590 NORWICH ST, FITCHBURG, WI 53711-5448
(815) 291-7831
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002122-15
WI
Other
Enumeration date
06/18/2019
Last updated
03/27/2020
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