Individual
PETER HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3064 S BUSINESS DR, SHEBOYGAN, WI 53081
(920) 278-7336
Mailing address
510 N 20TH ST APT 403, MILWAUKEE, WI 53233-2573
(360) 631-2884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001878-15
WI
Other
Enumeration date
05/30/2018
Last updated
06/27/2018
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