Individual
MRS. BETHANY LYN GALLISTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2524 E WEBSTER PL STE 201, MILWAUKEE, WI 53211-4257
(414) 963-9440
Mailing address
2954 N FRATNEY ST, MILWAUKEE, WI 53212-2626
(414) 688-8732
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10319-16
WI
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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