Individual
SHEPPARD B MOLLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10535 N PORT WASHINGTON RD, SUITE 102, MEQUON, WI 53092-5583
(414) 241-0900
(414) 241-0904
Mailing address
10535 N PORT WASHINGTON RD, SUITE 102, MEQUON, WI 53092-5583
(414) 241-0900
(414) 241-0904
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5001300-015
WI
Other
Enumeration date
10/02/2006
Last updated
02/05/2008
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