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Individual

JEFFREY M SEDLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
201 7TH ST S, LA CROSSE, WI 54601-4171
(608) 782-3003
Mailing address
201 7TH ST S, LA CROSSE, WI 54601-4171

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4418
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33766700
WI
Enumeration date
08/30/2006
Last updated
07/08/2007
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