Organization
ALISSA EDWARDS DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSA PONCZOCH (OWNER)
(414) 975-2240
Entity
Organization
Contact information
Practice address
229 E FRANKLIN ST, APPLETON, WI 54911-5434
(920) 733-2371
Mailing address
N2714 BUCKHORN DR, APPLETON, WI 54913-9611
(414) 975-2240
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2025
Last updated
04/30/2025
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