Gloria T List, DDS

NPI #1760733075 in Elm Grove, Wisconsin

Provider Information

NPI Number
1760733075
Entity Type
Individual
Name
Gloria T List, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Sep 26, 2012
Last Updated
Sep 26, 2012

Practice Location

Address
13105 WATERTOWN PLANK RD
ZIP Code
53122-2213
Phone
(262) 787-1460

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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