Individual
MR. JOHN F PESCH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OR
Contact information
Practice address
536 MAIN ST, BROWNSVILLE, WI 53006-0068
(920) 583-3454
(920) 583-3459
Mailing address
PO BOX 68, 536 MAIN ST, BROWNSVILLE, WI 53006-0068
(920) 583-3454
(920) 583-3459
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001392
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33613200
MEDICAL ASSISTANCE
WI
Enumeration date
12/19/2006
Last updated
07/08/2007
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