Individual
JESSICA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1270 W MAIN ST, SUN PRAIRIE, WI 53590-1930
(608) 825-7100
(608) 837-9134
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1002640-16
WI
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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