Individual
DR. MICHAEL GAVIN ROMENESKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2510 E EVERGREEN DR, APPLETON, WI 54913-8904
(920) 739-7848
Mailing address
2510 E EVERGREEN DR, APPLETON, WI 54913-8904
(920) 739-7848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6139-015
WI
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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