| Premier Periodontics Llc | |
|
2933 W Layton Ave Greenfield WI 53221-2626 | |
| (414) 282-2642 | |
| (414) 282-1952 |
| Full Name | Premier Periodontics Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2933 W Layton Ave, Greenfield, Wisconsin |
| Authorized Official Name and Position | Genevieve E Poppe (PARTNER) |
| Authorized Official Contact | 6083583370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Periodontics Llc 2933 W Layton Ave Greenfield WI 53221-2626 Ph: (414) 282-2642 | Premier Periodontics Llc 2933 W Layton Ave Greenfield WI 53221-2626 Ph: (414) 282-2642 |
| NPI Number | 1770911976 |
|---|---|
| Provider Enumeration Date | 10/24/2013 |
| Last Update Date | 10/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770911976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 5001847-15 (Wisconsin) | Primary |
| 1223P0300X | Dentist - Periodontics | 7160-15 (Wisconsin) | Secondary |
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