Individual
BRUCE WILLIAM LEBERECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1345 CHESTNUT ST, WEST BEND, WI 53095
(262) 338-6624
Mailing address
1345 CHESTNUT ST, WEST BEND, WI 53095
(262) 338-6624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5000972015
WI
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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