Individual
KENT H KILLIAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
49 N WALBRIDGE AVE, MADISON, WI 53714-3506
(608) 246-2555
Mailing address
6422 WYDOWN CIR, MIDDLETON, WI 53562-3847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4124-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33736500
—
WI
Enumeration date
06/02/2006
Last updated
07/09/2007
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