| Paradise Dental Professionals S.c. | |
|
1625 W Paradise Drive West Bend WI 53095 | |
| (262) 338-2992 | |
| (262) 338-6032 |
| Full Name | Paradise Dental Professionals S.c. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1625 W Paradise Drive, West Bend, Wisconsin |
| Authorized Official Name and Position | Cindy V Katt (MANAGER) |
| Authorized Official Contact | 2623382992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradise Dental Professionals S.c. 1625 W Paradise Drive West Bend WI 53095 Ph: (262) 338-2992 | Paradise Dental Professionals S.c. 1625 W Paradise Drive West Bend WI 53095 Ph: (262) 338-2992 |
| NPI Number | 1649492208 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649492208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2788 (Wisconsin) | Primary |
| 122300000X | Dentist | 2487 (Wisconsin) | Primary |
| 1223P0300X | Dentist - Periodontics | 2608 (Wisconsin) | Primary |
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