Individual
PROF. ROBERT RICHARD CHABALOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
58 RACINE ST, MENASHA, WI 54952-3154
(920) 725-8213
Mailing address
58 RACINE ST.POBOX 515, MENASHA, WI 54952-0515
(920) 725-8213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1457G
WI
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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