Search › Wisconsin › 122300000X
Jordan Boehlke
NPI 1770322026 · on the registry since 2024
Practice
- Address
- 1700 Coral Dr
Waukesha, WI 53186 - Phone
- (262) 650-3000
- Organisation at this address
- Proven Dental Llc
Keystone Waukesha Llc
Badger Medical Group S.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-01-24
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