Individual
DR. PAUL M ELCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1320 S GREENBAY RD, RACINE, WI 53406-4406
(262) 637-9371
Mailing address
1320 S GREENBAY RD, RACINE, WI 53406-4406
(262) 637-9371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5643015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33781900
—
WI
Enumeration date
02/23/2007
Last updated
07/08/2007
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