Individual
LEA MENDOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
139 S TAYLOR ST, GREEN BAY, WI 54303-2615
(920) 583-9051
Mailing address
139 S TAYLOR ST, GREEN BAY, WI 54303-2615
(920) 583-9051
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5201-16
WI
Other
Enumeration date
12/02/2021
Last updated
05/06/2024
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