Individual
MARYANN ALYCE FORSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8 BOON BLVD, NEILLSVILLE, WI 54456-2176
(715) 743-1950
Mailing address
8 BOON BLVD, NEILLSVILLE, WI 54456-2176
(402) 640-1217
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001843-15
WI
Other
Enumeration date
06/01/2018
Last updated
06/22/2023
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