Organization
PERIODONTICS AND IMPLANT DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER G HUTTON DDS (SOLE MEMBER)
(414) 369-2091
Entity
Organization
Contact information
Practice address
6754 LINDERMANN AVE, MOUNT PLEASANT, WI 53406-5603
(262) 632-5455
(262) 632-2858
Mailing address
6754 LINDERMANN AVE, MOUNT PLEASANT, WI 53406-5603
(262) 632-5455
(262) 632-2858
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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