Individual
JINKLE PRIVESH MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4445 TAYLOR AVE STE 1, MOUNT PLEASANT, WI 53405-4642
(262) 379-8761
Mailing address
113 CAMBRIAN CT, ROSELLE, IL 60172-4775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6002193-15
WI
Other
Enumeration date
06/17/2026
Last updated
06/17/2026
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