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1215160148
STEPHANIE NICOLE WAGONER KIMBALL
MADISON, WI
NPI
1215160148
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WI 6447-015)
Enumeration Date
2009-08-26
Last Update Date
2009-08-26
Business Address
Dr. STEPHANIE NICOLE WAGONER KIMBALL D.D.S.
621 S PARK ST
MADISON, WI 53715-1827
Phone number: 608-251-3535
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Mailing Address
Dr. STEPHANIE NICOLE WAGONER KIMBALL D.D.S.
621 S PARK ST
MADISON, WI 53715-1827
Phone number: 608-251-3535
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