Provider Demographics
NPI:1356414056
Name:ESSELMAN, JAMES M
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:ESSELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-1165
Mailing Address - Country:US
Mailing Address - Phone:715-886-5433
Mailing Address - Fax:715-886-5455
Practice Address - Street 1:315 1ST ST
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-1165
Practice Address - Country:US
Practice Address - Phone:715-886-5433
Practice Address - Fax:715-886-5455
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50018401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice