MARK WILLIAM DANTUMA

JANESVILLE, WI
NPI1407322084
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WI  8782-33)
Enumeration Date2018-10-22
Last Update Date2020-11-06
Business Address
MARK WILLIAM DANTUMA APNP
3200 E RACINE ST
JANESVILLE, WI 53546-2343
Phone number: 608-371-8000
Mailing Address
MARK WILLIAM DANTUMA APNP
500 W 190TH ST STE 400
GARDENA, CA 90248-4269
Phone number: 714-452-1961