Individual
DR. BLAIR DAVID MOLDENHAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
238 W MAIN ST, SUN PRAIRIE, WI 53590-2908
(608) 318-2119
(608) 318-2119
Mailing address
238 W MAIN ST, SUN PRAIRIE, WI 53590-2908
(608) 318-2119
(608) 318-2119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3331015
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3331015
WI
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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