Individual
MONICA PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2117 CORPORATE DR, WAUKESHA, WI 53189-7573
(608) 432-2552
Mailing address
2117 CORPORATE DR STE 300, WAUKESHA, WI 53189-7573
(608) 432-2552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.031160
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
1002269-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RES-30518
IA
Other
Enumeration date
07/12/2017
Last updated
08/14/2023
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