Individual
JORGE EDUARDO VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1801 W. WISCONSIN AVE, PFS-ROOM 145B, MILWAUKEE, WI 53233
(414) 288-8567
(414) 288-8361
Mailing address
PO BOX 1881, MILWAUKEE, WI 53201-1881
(414) 288-8393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18336875
WI
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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