Individual
DR. NICHOLAS EDWARD COUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4660 W COLLEGE AVE, APPLETON, WI 54913-8507
(920) 730-0345
Mailing address
1621 N LILAS DR, APPLETON, WI 54914-1203
(920) 997-0793
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5114
WI
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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