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PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS NPI 1962553834


NPI Information

NPI: 1962553834
Provider Name: PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
8405 W FOREST HOME AVE
SUITE 203
GREENFIELD, WI
ZIP 53228
Phone: (414) 425-7710
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PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS is a periodontics dentist in Greenfield, 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. PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS NPI is 1962553834. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8405 W FOREST HOME AVE
SUITE 203
GREENFIELD, WI
ZIP 53228-407
Phone: (414) 425-7710
Fax: (414) 425-7424

The provider's authorized official is Timothy J Mcnamara .
The authorized official title is President and has the following contact phone number (414) 425-7710.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/22/2020.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics2918WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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