Individual
JAN M WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
580 KASE ST, PLATTEVILLE, WI 53818-1814
(608) 348-3031
Mailing address
580 KASE ST, PO BOX 255, PLATTEVILLE, WI 53818-1814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4104
WI
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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