Individual
KEVIN SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
142 E CAPITOL DR, MILWAUKEE, WI 53212-1206
(414) 444-1823
Mailing address
3043 CREEKSIDE DR, PLAINFIELD, IL 60586-1764
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001058-15
WI
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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