TIMOTHY RAYMOND WALL

PEWAUKEE, WI
NPI1932255627
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WI  3951-015)
Enumeration Date2007-01-26
Last Update Date2007-07-08
Business Address
Dr. TIMOTHY RAYMOND WALL dds
250 CLARK ST
PEWAUKEE, WI 53072-3529
Phone number: 262-695-9392
Mailing Address
Dr. TIMOTHY RAYMOND WALL dds
250 CLARK ST
PEWAUKEE, WI 53072-3529
Phone number: 262-695-9392