| Kittleson Orthodontics, S.c. | |
|
10521 N Port Washington Rd Mequon WI 53092-5584 | |
| (262) 241-3141 | |
| Not Available |
| Full Name | Kittleson Orthodontics, S.c. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 10521 N Port Washington Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | John Clayton Kittleson (VICE-PRESIDENT) |
| Authorized Official Contact | 2622413141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kittleson Orthodontics, S.c. 10521 N Port Washington Rd Mequon WI 53092-5584 Ph: (262) 241-3141 | Kittleson Orthodontics, S.c. 10521 N Port Washington Rd Mequon WI 53092-5584 Ph: (262) 241-3141 |
| NPI Number | 1073828604 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 08/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073828604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 4648-015 (Wisconsin) | Primary |
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