| St Croix Periodontics | |
|
1200 Crestview Drive Suite4 Hudson WI 54016-9391 | |
| (715) 377-7860 | |
| (715) 377-7862 |
| Full Name | St Croix Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1200 Crestview Drive, Hudson, Wisconsin |
| Authorized Official Name and Position | James Robert Norris (PRESIDENT) |
| Authorized Official Contact | 7153777860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Croix Periodontics 1200 Crestview Drive Suite 4 Hudson WI 54016-9391 Ph: (715) 377-7860 | St Croix Periodontics 1200 Crestview Drive Suite4 Hudson WI 54016-9391 Ph: (715) 377-7860 |
| NPI Number | 1669684726 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669684726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 5100 (Wisconsin) | Primary |
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