VALLEY PERIODONTICS S.C. NPI 1821156241

NPI Information

VALLEY PERIODONTICS, S.C. is a periodontics dentist in Appleton, 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. VALLEY PERIODONTICS, S.C. NPI is 1821156241. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2535 NORTHER ROAD
APPLETON, WI
ZIP 54914
Phone: (920) 731-3224
Fax: (920) 731-2910

The provider's authorized official is S. Timothy Rose .
The authorized official title is President and has the following contact phone number (920) 731-3224.

The CLIA number assigned to this NPI record is 52D0695199 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2006 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:

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