Affordable Dentures & Implants - Kenosha III, S.C.
Organization Active NPI General Practice Dentistry · Pleasant Prairie, WI
NPI 1104647957 · NPPES record last updated Oct 23, 2024
Key facts
- NPI
- 1104647957
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- AFFORDABLE DENTURES & IMPLANTS - KENOSHA III, S.C.
- Practice address
- 10347 77TH St Ste 630
Pleasant Prairie, WI 53158-1138 - Phone
- (262) 694-6360
- NPI assigned
- Oct 23, 2024
- Organization subpart
- No
Authorized official
- Name
- Zahir Siddiqui, DMD
- Title
- Managing Dentist
- Phone
- (262) 694-6360
Practitioners 1
-
Ivan A Martino, D.D.S.
National Provider Directory
Locations
10347 77th St
Ste 630
Pleasant Prairie, WI 53158
Phone (262) 694-6360
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
10347 77TH St Ste 630
Pleasant Prairie, WI 53158-1138
Mailing address
10347 77TH St Ste 630
Pleasant Prairie, WI 53158-1138
Phone (262) 694-6360
Other names
- Affordable Dentures & Implants - Kenosha
Other providers in Pleasant Prairie, WI
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- Anika Alam
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- Thomas M Ambro
- Daisy Andaleon
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All providers in Pleasant Prairie, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.