Individual
TRACEY LOSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
(920) 882-2946
Mailing address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
(920) 882-2946
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
100299716
WI
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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