Individual
DR. PHILLIP LEE BANGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1425 SUMMIT AVE STE 200, WAUKESHA, WI 53188-3200
(262) 542-1662
Mailing address
1425 SUMMIT AVE STE 200, WAUKESHA, WI 53188-3200
(262) 542-1662
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2318
WI
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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