Organization
PERIO-DENTAL IMPLANTS, LLC
Active
Other names
The Center for Periodontics and Dental Implants
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW THOMAS FABIAN (MANAGER)
(608) 712-6320
Entity
Organization
Contact information
Practice address
6301 UNIVERSITY AVE, MIDDLETON, WI 53562-3415
(608) 709-1240
(608) 819-8395
Mailing address
6301 UNIVERSITY AVE, MIDDLETON, WI 53562-3415
(608) 709-1240
(608) 819-8395
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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