Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 1001765-16 | WI |
NPI | 1033631247 |
---|---|
Provider Name | Julie Geigner |
First Address | Wautoma, WI 54982-1440 |
Second Address | Beaver Dam, WI 53916-2450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 10/07/2017 |