Individual
MRS. THERESA MATUSIEWICZ POPOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H
Contact information
Practice address
88455 PIKE RD, BAYFIELD, WI 54814-4814
(715) 779-3096
Mailing address
88455 PIKE ROAD, BAYFIELD, WI 54814-4814
(715) 779-3096
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6918-016
WI
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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