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Organization

DOUGLAS PERSICH, DDS

Active
Other names
West Allis Dental Care, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOUGLAS J PERSICH II DDS (OWNER)
(414) 258-2500
Entity
Organization

Contact information

Practice address
7130 W GREENFIELD AVE, WEST ALLIS, WI 53214-4708
(414) 258-2500
(414) 238-6881
Mailing address
7130 W GREENFIELD AVE, WEST ALLIS, WI 53214-4708
(414) 258-2500
(414) 238-6881

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001644
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38357100
WI
Enumeration date
10/18/2006
Last updated
08/22/2020
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