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1528264819
RUSSELL THEODORE KITTLESON
MEQUON, WI
NPI
1528264819
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: WI 4001404)
Enumeration Date
2007-06-22
Last Update Date
2007-07-08
Business Address
-- RUSSELL THEODORE KITTLESON DDS
10521 N PORT WASHINGTON RD # 13W
MEQUON, WI 53092-5584
Phone number: 262-241-3142
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Mailing Address
-- RUSSELL THEODORE KITTLESON DDS
10521 N PORT WASHINGTON RD # 13W
MEQUON, WI 53092-5584
Phone number: 262-241-3142
Copy
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