Persich, Douglas
Persich, Douglas is an sole proprietor health care provider with primary practice located at 7130 W Greenfield Ave , West Allis WI 53214-4708. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Persich, Douglas can be contacted via phone (414) 258-2500.Contact Information
Primary practice address
7130 W Greenfield Ave
West Allis WI 53214-4708
Phone: (414) 258-2500
Fax: (414) 238-6881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 5001644 | Wisconsin |
Profile Details
| NPI number | 1205082377 |
|---|---|
| LBN Legal business name | Persich, Douglas |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 8th, 2008 |
| Last updated | Aug 8th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205082377 | NPPES |
| Wisconsin | MEDICAID | 33540100 |
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