# PARAMOUNT PEDIATRIC DENTISTRY OF RACINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619507357
- **Authorized official:** ALEXIS B COLOSIMO DDS (DENTIST/OWNER)
- **Authorized official phone:** (651) 470-0541

## Contact information

- **Practice address:** 5820 WASHINGTON AVE, MT PLEASANT, WI 53406-4020
- **Practice address phone:** (262) 770-5848
- **Practice address fax:** (262) 770-5751
- **Mailing address:** 5820 WASHINGTON AVE, MT PLEASANT, WI 53406-4020
- **Mailing address phone:** (262) 770-5848
- **Mailing address fax:** (262) 770-5751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2020
- **Last updated:** 01/22/2020