Individual
MCKENNA MARIA MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1272 LONGTAIL BEACH RD, SUAMICO, WI 54173-8037
(920) 569-9313
Mailing address
1272 LONGTAIL BEACH RD, SUAMICO, WI 54173-8037
(920) 569-9313
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001565
WI
Other
Enumeration date
04/29/2024
Last updated
07/29/2024
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