Individual
MADISON ROSE GELICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3415 30TH AVE, KENOSHA, WI 53144-1622
(262) 654-0267
Mailing address
3415 30TH AVE, KENOSHA, WI 53144-1622
(262) 654-0267
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002562-15
WI
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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