Individual
JODI L MANSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2253 16TH ST, MONROE, WI 53566-2604
(608) 558-5912
Mailing address
2253 16TH ST, MONROE, WI 53566-2604
(608) 558-5912
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6469-016
WI
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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