# PARAMOUNT PEDIATRIC DENTISTRY SC

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

## Provider details

- **NPI number:** 1831545763
- **Authorized official:** DR. CHRISTY L FRADY DMD (DENTIST)
- **Authorized official phone:** (414) 529-1110

## Contact information

- **Practice address:** 11035 W FOREST HOME AVE, SUITE116, HALES CORNERS, WI 53130-2541
- **Practice address phone:** (414) 529-1110
- **Practice address fax:** (414) 529-1134
- **Mailing address:** 11035 W FOREST HOME AVE, SUITE116, HALES CORNERS, WI 53130-2541
- **Mailing address phone:** (414) 529-1110
- **Mailing address fax:** (414) 529-1134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 6219 | WI | Yes |

## Other

- **Enumeration date:** 05/10/2016
- **Last updated:** 05/11/2016