Individual
CHRISTINA COPOULOS-SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
850 SUMMIT AVE STOP 1, OCONOMOWOC, WI 53066-3920
(262) 567-0470
Mailing address
418 W 5TH ST, OCONOMOWOC, WI 53066-3534
(414) 807-7805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001198-15
WI
Other
Enumeration date
05/10/2023
Last updated
06/26/2023
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