| Racine Periodontics And Implant Dentistry Ltd | |
|
255 Havenwood Dr Lake Geneva WI 53147-1988 | |
| (262) 248-8505 | |
| Not Available |
| Full Name | Racine Periodontics And Implant Dentistry Ltd |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 255 Havenwood Dr, Lake Geneva, Wisconsin |
| Authorized Official Name and Position | Adrian Rivas (OWNER) |
| Authorized Official Contact | 3058079082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Racine Periodontics And Implant Dentistry Ltd 4715 James Ave Racine WI 53402-2642 Ph: (305) 807-9082 | Racine Periodontics And Implant Dentistry Ltd 255 Havenwood Dr Lake Geneva WI 53147-1988 Ph: (262) 248-8505 |
| NPI Number | 1215634266 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 02/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215634266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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