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General NPI Number Information
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NPI Number | 1710721980
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Entity Type | Individual
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Provider Name | LESTER FRANCIS CEDNICK III D.D.S
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Gender | Male
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 06/22/2024
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Provider Practice Location Address
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Address Line | 613 N 36TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53208-3815
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Country | US
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Telephone | 414-454-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 N OAKLAND AVE
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City | MILWAUKEE
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State | WI
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Zip | 53202-1412
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Country | US
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Telephone | 847-975-6627
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6001588-15
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License Number State | WI
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