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Individual

ALINE DUFRESNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D

Contact information

Practice address
10155 WASHINGTON AVE, STURTEVANT, WI 53177-1645
(262) 664-7743
(262) 664-7799
Mailing address
1635 N WATER ST, APT 507, MILWAUKEE, WI 53202-2793
(410) 491-4454

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1001422-15
WI
1223P0221X
Pediatric Dentistry
15724
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
097733100
MD
Enumeration date
05/31/2013
Last updated
04/25/2017
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