Southport Periodontics
Southport Periodontics provides Periodontics in Kenosha, Wisconsin. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
5021 Washington RdKenosha, WI 53144
Phone: (262) 654-6770
Fax: (262) 654-6727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X |
|---|
Record details
| NPI number | 1679064901 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Patricia Jenkins — Manager · (262) 654-6770 |
| NPI enumerated | May 22, 2018 |
| Last updated in NPPES | May 22, 2018 |
| Mailing address | 5021 Washington Rd, Kenosha, WI 53144-4292 |
Other providers in Kenosha
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Dr. Dennis M Connolly, DDSMS
2901 35th St, Kenosha, WI 53140-5119 · (262) 658-3488