Individual
DR. JAMES MICHAEL PODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3108
(414) 777-3817
(414) 771-7640
Mailing address
907 RIVER RESERVE DR, HARTLAND, WI 53029-2913
(262) 367-3619
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4866-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33744900
—
WI
Enumeration date
07/14/2006
Last updated
07/08/2007
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