Individual
MARY PRAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4302 N 76TH ST, MILWAUKEE, WI 53222-2004
(414) 462-9420
Mailing address
4302 N 76TH ST, MILWAUKEE, WI 53222-2004
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10098-16
WI
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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