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Organization
AG PERIO LLC
Active
Organization
AG PERIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA A GARCIA RDH (OFFICE MANAGER)
(262) 547-1877
Entity
Organization
Contact information
Practice address
2316 N GRANDVIEW BLVD, WAUKESHA, WI 53188-5318
(262) 547-1877
Mailing address
2316 N GRANDVIEW BLVD, WAUKESHA, WI 53188-1602
(262) 547-1877
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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