Individual
DR. JERRY LEE CEILESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
21425 SPRING ST, UNION GROVE, WI 53182-9707
(262) 878-2411
(262) 878-2922
Mailing address
21425 SPRING ST, UNION GROVE, WI 53182-9707
(262) 878-2411
(262) 878-2922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5001598-015
WI
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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