Organization
PARAMOUNT PEDIATRIC DENTISTRY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTY L FRADY DMD (DENTIST)
(414) 529-1110
Entity
Organization
Contact information
Practice address
11035 W FOREST HOME AVE, SUITE116, HALES CORNERS, WI 53130-2541
(414) 529-1110
(414) 529-1134
Mailing address
11035 W FOREST HOME AVE, SUITE116, HALES CORNERS, WI 53130-2541
(414) 529-1110
(414) 529-1134
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6219
WI
Other
Enumeration date
05/10/2016
Last updated
05/11/2016
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