Individual
PIERCE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
545 E JOHNSON ST, FOND DU LAC, WI 54935-2856
(920) 924-9090
Mailing address
540 VAN DYNE RD, 203, FOND DU LAC, WI 54937-1817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001354-15
WI
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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