Racine Periodontics and Implant Dentistry Ltd
NPI #1215634266 in Lake Geneva, Wisconsin
Provider Information
- NPI Number
- 1215634266
- Entity Type
- Organization
- Organization Name
- Racine Periodontics and Implant Dentistry Ltd
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Feb 9, 2023
- Last Updated
- Feb 9, 2023
Practice Location
- Address
- 255 HAVENWOOD DR
- City
- Lake Geneva
- State
- Wisconsin
- ZIP Code
- 53147-1988
- Phone
- (262) 248-8505
Authorized Official
- Name
- DR. ADRIAN RIVAS, DMD
- Title
- OWNER
- Phone
- (305) 807-9082
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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