Organization · Type 2 NPI
Susan Stacker DDS SC
Periodontics · Wausau, WI
NPI number
1497819585
Active
Practice location
1220 6th Street
Wausau, WI 54403-3550
Fax (715) 845-4509
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| 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.
About NPI 1497819585
Susan Stacker DDS SC's National Provider Identifier is 1497819585, issued on Dec 21, 2006. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Wausau, WI. The record was last updated on Aug 22, 2020.