Organization
MICHAEL DE WAN DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL S DE WAN (DENTIST)
(414) 962-5915
Entity
Organization
Contact information
Practice address
2577 N DOWNER AVE, STE 202, MILWAUKEE, WI 53211-4242
(414) 962-5915
Mailing address
2577 N DOWNER AVE, STE 202, MILWAUKEE, WI 53211-4253
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
WI3976
WI
Other
Enumeration date
05/22/2008
Last updated
06/12/2008
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