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Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.C.

Dentist, Oral and Maxillofacial Surgery in Greenfield, WI. Organization (NPI-2).

NPI number1285649921
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1285649921
Entity type
Organization (NPI-2)
Legal business name
Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.C.
Organization subpart
No
Enumeration date
Jul 30, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223S0112X Dentist, Oral and Maxillofacial Surgery2699WIYes

Practice location

4811 S 76th St
Suite 304
Greenfield, WI 53220-4364

Phone 414-281-3344 · Fax 414-281-1080

Mailing address

4811 S 76th St
Suite 304
Greenfield, WI 53220-4364

Phone 414-281-3344 · Fax 414-281-1080

Authorized official

Ronald Henry Nellen
President
4142813344

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