NPI 1134339500

Fox River Periodontics Sc

Organisation Periodontics Appleton, WI

Practice location

Address: 2557b East Calumet St, Appleton, WI 54915
Phone: (920) 733-7770
Fax: (920) 733-7798

Authorised official

Name: Jason William Cooke
Title: President
Phone: (920) 733-7770

Registered specialties

Periodontics Primary

Dental Providers Taxonomy 1223P0300X Licence 5864-015 (WI)

Other Dentist providers in Wisconsin →

Registry record

NPI: 1134339500
Entity type: Organization
NPI issued: 23 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.