Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SOUTHPORT PERIODONTICS
Active OrganizationSOUTHPORT PERIODONTICS is a Periodontology organization located in KENOSHA, Wisconsin. NPI 1679064901 is currently active in the NPPES registry. Verify at CMS.
Periodontology · KENOSHA, WI
Registration Details
- NPI Number
- 1679064901
- Provider Type
- Organization
- NPI Issued
- May 22, 2018 (8.2636550343045 yrs)
- Last Updated
- May 22, 2018
Practice Information
- Address
-
5021 WASHINGTON RDKENOSHA, WI, 53144Browse WI providers · Browse ZIP 53144
- Phone
- 2626546770
- Fax
- 2626546727
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.