Organization
J P IRELAN ENDODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON IRELAN DDS (OWNER)
(262) 632-5455
Entity
Organization
Contact information
Practice address
6754 LINDERMANN AVE, MOUNT PLEASANT, WI 53406-5603
(262) 632-5455
(262) 632-2858
Mailing address
6100 W STATE ST APT 531, WAUWATOSA, WI 53213-4604
(503) 715-6971
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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