Individual
MS. JODI NEISES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGENIST
Contact information
Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
(262) 653-2218
Mailing address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
(262) 653-2218
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6364
WI
Other
Enumeration date
11/16/2009
Last updated
11/16/2009
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