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Organization
SUMMIT SQUARE DENTAL LLC
Active
Organization
SUMMIT SQUARE DENTAL LLC
Active
Parent organization
STEPPING STONE DENTAL PARTNERS
Other names
Summit Square Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEPPING STONE DENTAL PARTNERS
Authorized official
TIMOTHY J MATHISON (PRESIDENT & CEO)
(608) 709-8303
Entity
Organization
Contact information
Practice address
3228 TURNBERRY OAK DR, WAUKESHA, WI 53188-3969
(262) 544-0171
Mailing address
3228 TURNBERRY OAK DR, WAUKESHA, WI 53188-3969
(262) 544-0171
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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