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Southport Periodontics
Periodontist in Kenosha, Wisconsin
NPI 1679064901

Southport Periodontics is a Periodontist based in Kenosha, WI and is specialized in Periodontics. Southport Periodontics practices in Kenosha, WI. The NPI Number for Southport Periodontics is 1679064901 and holds a License No. (Wisconsin).

The current practice location address for Southport Periodontics is 5021 Washington Rd, Kenosha, WI and can be reached out via phone at 262-654-6770 and via fax at 262-654-6727.

Location: 5021 Washington Rd, Kenosha, WI, 53144-4292
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679064901
Provider Name
Southport Periodontics
Credential
Provider Entity Type
Organization
Address
5021 Washington Rd, Kenosha, WI, 53144-4292
Phone Number
262-654-6770
Fax Number
262-654-6727
Provider Enumeration Date
05/22/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5021 Washington Rd
City
Kenosha
State
Wisconsin
Zip
53144
Phone Number
262-654-6770
Fax Number
262-654-6727
person
Provider Business Mailing Address Details
Address
5021 Washington Rd
City
Kenosha
State
Wisconsin
Zip
53144
Phone Number
262-654-6770
Fax Number
262-654-6727
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
()
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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