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Individual

ELIZABETH S DIETZLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
4619 W BLUE MOUND CT, MILWAUKEE, WI 53208-3607
(414) 339-5523
Mailing address
4619 W BLUE MOUND CT, MILWAUKEE, WI 53208-3607
(414) 339-5523

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10453-016
WI

Other

Enumeration date
03/25/2014
Last updated
03/25/2014
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