Individual
DR. EUGENE THEODORE KWIECIEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6882 W JOHNSON RD, LAPORTE, IN 46350-8247
(219) 879-5131
Mailing address
6882 W JOHNSON RD, LAPORTE, IN 46350-8247
(219) 879-5131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006674
IN
Other
Enumeration date
11/17/2005
Last updated
07/08/2007
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