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Individual

ROBERT YOUNGQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
255 HAVENWOOD DR, LAKE GENEVA, WI 53147-1988
(262) 248-0101
Mailing address
255 HAVENWOOD DR, LAKE GENEVA, WI 53147-1988
(262) 248-0101

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2191
WI

Other

Enumeration date
03/03/2015
Last updated
03/03/2015
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