Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 5120015 | WI |
N | 1223P0106X | Oral and Maxillofacial Pathology | 5120015 | WI |
NPI | 1447333414 |
---|---|
Provider Name | Dr. David John Landwehr |
First Address | Madison, WI 53718-2425 |
Second Address | Madison, WI 53718-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 13/07/2017 |