Individual
JOHN MICHAEL KOSMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9762 WEST LAKE AVENUE, MINOCQUA, WI 54548
(715) 358-3321
Mailing address
PO BOX 1027, MINOCQUA, WI 54548
(715) 358-3321
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4694
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33727700
—
WI
Enumeration date
12/31/2007
Last updated
12/31/2007
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