Individual
DANIELLE THEA MUCKENTHALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
(262) 649-1977
Mailing address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
(262) 649-1977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26226
FL
1223G0001X
General Practice Dentistry
2901019992
MI
Other
Enumeration date
07/10/2009
Last updated
07/01/2025
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