# WATERFORD CHILDRENS DENTISTRY SC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARAMOUNT PEDIATRIC DENTISTRY SC
- **Other names:** Paramount Pediatric Dentistry, Waterford Childrens Dentistry SC, Paramount Pediatric Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982385944
- **Legal business name:** PARAMOUNT PEDIATRIC DENTISTRY SC
- **Authorized official:** CHRISTY FRADY DMD (OWNER)
- **Authorized official phone:** (414) 350-0945

## Contact information

- **Practice address:** 790 CORNERSTONE XING, WATERFORD, WI 53185-4582
- **Practice address phone:** (414) 350-0945
- **Mailing address:** 790 CORNERSTONE XING, WATERFORD, WI 53185-4582
- **Mailing address phone:** (414) 350-0945

## Taxonomy

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

## Other

- **Enumeration date:** 07/31/2023
- **Last updated:** 07/31/2023