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MR. JEROME ALLEN LANG DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1497829485

Individual Registrant:
MR. JEROME ALLEN LANG DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
105 KELLY WAY  HORTONVILLE, WI 54944 US
Tel: 920-779-4982  Fax: 920-779-0930

Contact information for business:
105 KELLY WAY  HORTONVILLE, WI 54944 US
Tel: 920-779-4982  Fax: 920-779-0930

Registration Information:
NPI: 1497829485
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
WI5001375

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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