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Individual

DAMON COLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
413 N 17TH AVE, WAUSAU, WI 54401-4611
(520) 350-7560
Mailing address
413 N 17TH AVE, WAUSAU, WI 54401-4611
(715) 551-9660

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1002710
WI

Other

Enumeration date
04/09/2021
Last updated
09/05/2023
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