Individual
MICHAEL JON VITENSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
625 WALNUT RIDGE DR SUITE 102, HARTLAND, WI 53029
(262) 367-4255
(262) 367-4714
Mailing address
625 WALNUT RIDGE DR SUITE 102, HARTLAND, WI 53029
(262) 367-4255
(262) 367-4714
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1722-G
WI
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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