Wisconsin Oral Medicine LLC
Dentist, Oral and Maxillofacial Surgery in Greenfield, WI. Organization (NPI-2).
NPI number1417740465
StatusActive
Last updated in NPPESMay 23, 2025
Details
- NPI
- 1417740465
- Entity type
- Organization (NPI-2)
- Legal business name
- Wisconsin Oral Medicine LLC
- Organization subpart
- No
- Enumeration date
- May 23, 2025
- Certification date
- May 23, 2025
- Last updated
- May 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | Yes |
Practice location
8405 W Forest Home AveGreenfield, WI 53228-3407
Phone 443-255-8743
Mailing address
6400 Industrial LoopGreendale, WI 53129-2452
Phone 414-858-4125 · Fax 414-423-4134
Authorized official
Bhavik Desai
Owner
4432558743
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All 8 Oral and Maxillofacial Surgery (Dentist) providers in Greenfield · All 1,185 providers in Greenfield
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