Organization
MICHAEL A WALSH DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANTHONY WALSH DDS (OFFICER)
(262) 658-1410
Entity
Organization
Contact information
Practice address
2600 22ND AVE, KENOSHA, WI 53140
(262) 658-1410
(262) 658-1410
Mailing address
2600 22ND AVE, KENOSHA, WI 53140
(262) 658-1410
(262) 658-1448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001276015
WI
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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