Healthcare Provider Details

I. General information

NPI: 1740197276
Provider Name (Legal Business Name): IMPLANTOLOGIE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8409 402ND AVE.
GENOA CITY WI
53128
US

IV. Provider business mailing address

8425 402ND AVE
GENOA CITY WI
53128-1207
US

V. Phone/Fax

Practice location:
  • Phone: 618-977-9106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLISON KATE ALBERTS
Title or Position: OWNER
Credential: DDS
Phone: 618-977-9106