Individual
LESLEE C TIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 784-7319
(608) 784-4384
Mailing address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 784-7319
(608) 784-4384
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
6076
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6076
WI
Other
Enumeration date
02/02/2007
Last updated
03/04/2019
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