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Individual

MONICA L. DENTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-A

Contact information

Practice address
3230 OLD LANTERN DR, BROOKFIELD, WI 53005-3016
(262) 783-7731
Mailing address
3230 OLD LANTERN DR, BROOKFIELD, WI 53005-3016
(262) 783-7731

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
198-156
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1619286408
WI
01
P00959860
RAILROAD
Enumeration date
09/28/2010
Last updated
10/24/2013
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