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Search › Wisconsin › General Practice Dentistry

Mark Waller, D.D.S

NPI 1679670046 · on the registry since 2006 · sole proprietor

Practice

Address
N63 W23401 Main St
Sussex, WI 53089
Phone
(262) 246-6806
Fax
(262) 246-6892
Organisation at this address
Deborah A Archilletti Dds Sc
Karen M. Boettcher, D.D.S.,S.C.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
General Practice Dentistry
1223G0001X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin