Eau Claire Periodontics, L.l.c.
NPI #1578832853 in Eau Claire, Wisconsin
Provider Information
- NPI Number
- 1578832853
- Entity Type
- Organization
- Organization Name
- Eau Claire Periodontics, L.l.c.
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Dec 15, 2011
- Last Updated
- Dec 15, 2011
Practice Location
- Address
- 2125 HEIGHTS DR STE 2C
- City
- Eau Claire
- State
- Wisconsin
- ZIP Code
- 54701-6146
- Phone
- (715) 832-5396
Authorized Official
- Name
- DR. JASON D. JOHNSON, D.D.S., M.S.
- Title
- CHIEF MANAGER/PERIODONTIST
- Phone
- (715) 832-5396
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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