Individual
KEVIN MADERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 W LINCOLN AVE, MILWAUKEE, WI 53215
(414) 662-0235
Mailing address
1300 W LINCOLN AVE, MILWAUKEE, WI 53215
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001208-15
WI
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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