Individual
DR. VRISIIS KOFINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-5902
Mailing address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-5902
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
18301-875
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18301-875
WI DENTAL FACULTY LICENSE
WI
Enumeration date
07/16/2015
Last updated
09/09/2019
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