| Vista Family Dentistry, Llc | |
|
20855 Watertown Rd Suite 120 Waukesha WI 53186-1860 | |
| (262) 717-9104 | |
| (262) 717-9105 |
| Full Name | Vista Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 20855 Watertown Rd, Waukesha, Wisconsin |
| Authorized Official Name and Position | Vassilis K Panagopoulos (DENTIST/PRESIDENT) |
| Authorized Official Contact | 2627179104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Family Dentistry, Llc 20855 Watertown Rd Suite 120 Waukesha WI 53186-1860 Ph: (262) 717-9104 | Vista Family Dentistry, Llc 20855 Watertown Rd Suite 120 Waukesha WI 53186-1860 Ph: (262) 717-9104 |
| NPI Number | 1861927535 |
|---|---|
| Provider Enumeration Date | 05/01/2017 |
| Last Update Date | 05/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861927535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6265-15 (Wisconsin) | Primary |
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