ERNST A. CORNIELSEN

LAKE GENEVA, WI
NPI1447268651
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: WI  1732-G)
Additional Taxonomies1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL  019014281)
Enumeration Date2006-08-03
Last Update Date2007-07-08
Business Address
-- ERNST A. CORNIELSEN D.D.S.
312 CENTER ST
LAKE GENEVA, WI 53147-1904
Phone number: 262-248-2868
Mailing Address
-- ERNST A. CORNIELSEN D.D.S.
W3627 WILDWOOD DR
LAKE GENEVA, WI 53147-3568
Phone number: 262-248-2868