Individual
DR. TRISTEN LEE EVLETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
N80W17707 CUSTER LN, MENOMONEE FALLS, WI 53051-3630
(262) 214-5907
Mailing address
N80W17707 CUSTER LN, MENOMONEE FALLS, WI 53051-3630
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001442-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/08/2024
Last updated
05/02/2024
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