Individual
DR. NIKITA GEORGE TONGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
825 W FULTON ST, WAUPACA, WI 54981-1471
(920) 731-7445
Mailing address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6001080-15
WI
1223G0001X
General Practice Dentistry
Primary
6001080-15
WI
Other
Enumeration date
04/19/2023
Last updated
08/14/2024
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