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1679612204
MAYLANI EVANGELISTA
KENOSHA, WI
NPI
1679612204
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: WI 5469)
Enumeration Date
2007-02-06
Last Update Date
2007-07-08
Business Address
Dr. MAYLANI EVANGELISTA
3410 80TH ST
KENOSHA, WI 53142-4975
Phone number: 262-697-0825
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Mailing Address
Dr. MAYLANI EVANGELISTA
3410 80TH ST
KENOSHA, WI 53142-4975
Phone number: 262-697-0825
Copy
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