Individual
HEATHER SUE MARQUARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2214 SAMANTHA ST, DE PERE, WI 54115-8030
(920) 562-2714
Mailing address
2214 SAMANTHA ST, DE PERE, WI 54115-8030
(920) 562-2714
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11097
WI
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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