Individual provider · Type 1 NPI
Susan Stacker
Periodontics · Wausau, WI
NPI number
1306903786
Active
Practice location
1220 N 6 Street
Wausau, WI 54401-1220
Fax (715) 845-4509
Mailing address
1220 N 6 Street
Wausau, WI 54403-1220
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics | 1223P0300X | 4828 (IL) |
| Periodontics Primary | 1223P0300X | 4828 (WI) |
Periodontics: 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.
Other periodontics providers in Wausau
About NPI 1306903786
Susan Stacker's National Provider Identifier is 1306903786, issued on Jan 3, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Wausau, WI. The record was last updated on Mar 4, 2014.