MAYLANI EVANGELISTA

KENOSHA, WI
NPI1679612204
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: WI  5469)
Enumeration Date2007-02-06
Last Update Date2007-07-08
Business Address
Dr. MAYLANI EVANGELISTA
3410 80TH ST
KENOSHA, WI 53142-4975
Phone number: 262-697-0825
Mailing Address
Dr. MAYLANI EVANGELISTA
3410 80TH ST
KENOSHA, WI 53142-4975
Phone number: 262-697-0825
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