Organization
ASSOCIATED PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SVOBODA DDS, MSD (OWNER)
(920) 922-7700
Entity
Organization
Contact information
Practice address
525 E DIVISION ST, FOND DU LAC, WI 54935-3747
(920) 922-7700
Mailing address
525 E DIVISION ST, FOND DU LAC, WI 54935-3747
(920) 922-7700
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2302-015
WI
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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