=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740197276
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IMPLANTOLOGIE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2026
-----------------------------------------------------
Last Update Date | 08/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8409 402ND AVE.
-----------------------------------------------------
City | GENOA CITY
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-977-9106
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8425 402ND AVE
-----------------------------------------------------
City | GENOA CITY
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53128-1207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALLISON KATE ALBERTS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 618-977-9106
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------