EAU CLAIRE PERIODONTICS L.L.C. NPI 1578832853

NPI Information

EAU CLAIRE PERIODONTICS, L.L.C. is a periodontics dentist in Eau Claire, WI. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. EAU CLAIRE PERIODONTICS, L.L.C. NPI is 1578832853. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2125 HEIGHTS DR STE 2C
EAU CLAIRE, WI
ZIP 54701-146
Phone: (715) 832-5396
Fax: (715) 832-3009

The provider's authorized official is Jason D. Johnson .
The authorized official title is Chief Manager/periodontist and has the following contact phone number (715) 832-5396.

The enumeration date for this NPI number is 12/15/2011 and was last updated on 12/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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