Eau Claire Periodontics, L.L.C.
Periodontist in Eau Claire, WI(View on Map)
Legal Business Name
Eau Claire Periodontics, L.L.C.
NPI Number
1578832853
NPI Type
Organization
Enumeration Date
12/15/2011
Specialties
(Taxonomies)Licenses
State
Wisconsin
License Number
6810-015
Contact
Information
Purpose
Mailing
Location
Address
2125 HEIGHTS DR STE 2C
2125 HEIGHTS DR STE 2C
City
Eau Claire
Eau Claire
State
WI
WI
Postal Code
54701-6146
54701-6146
Country
US
US
Telephone Number
(715) 832-5396
(715) 832-5396
Authorized Official
Name
Dr. Jason Johnson
Title or Position
CHIEF MANAGER/PERIODONTIST
Telephone Number
(715) 832-5396
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/15/2011
Provider Address
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