Individual
MARY BREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 E COMMERCE CT, ELKHORN, WI 53121-4360
(262) 686-1388
Mailing address
205 E COMMERCE CT, ELKHORN, WI 53121-4360
(262) 686-1388
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4668
WI
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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