JACOB ROBERT WALLOCK

FOND DU LAC, WI
NPI1902485725
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WI  1002568-15)
Enumeration Date2021-04-07
Last Update Date2021-06-17
Business Address
JACOB ROBERT WALLOCK DDS
145 S MARR ST
FOND DU LAC, WI 54935-4408
Phone number: 920-922-9000
Mailing Address
JACOB ROBERT WALLOCK DDS
1801 W WISCONSIN AVE
MILWAUKEE, WI 53233-2186
Phone number: 414-322-9456
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