Individual
DR. ALAN JOSEPH WICKENHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
708 E BETHALTO BLVD, BETHALTO, IL 62010-1871
(618) 377-0044
Mailing address
708 E BETHALTO BLVD, BETHALTO, IL 62010-1871
(618) 377-0044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-024793
IL
Other
Enumeration date
02/01/2008
Last updated
08/09/2017
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