Individual
DR. ETHAN JUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
340 E REED AVE, MANITOWOC, WI 54220-2123
(920) 214-9828
Mailing address
1732 BLUE HERON RD, MANITOWOC, WI 54220-9445
(920) 629-1096
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6001067-15
WI
Other
Enumeration date
11/01/2023
Last updated
04/16/2025
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