Center For Oral & Maxillofacial Surgery Sc | |
7007 Old Sauk Rd Madison WI 53713 | |
(608) 833-2060 | |
(608) 833-1737 |
Full Name | Center For Oral & Maxillofacial Surgery Sc |
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Speciality | Dentist |
Location | 7007 Old Sauk Rd, Madison, Wisconsin |
Authorized Official Name and Position | Gary W. Sweeney (S CORP PRESIDENT) |
Authorized Official Contact | 6088332060 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Center For Oral & Maxillofacial Surgery Sc 20 S Park St #506 Madison WI 53715 Ph: (608) 256-1961 | Center For Oral & Maxillofacial Surgery Sc 7007 Old Sauk Rd Madison WI 53713 Ph: (608) 833-2060 |
NPI Number | 1710900808 |
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Provider Enumeration Date | 07/26/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 5294830451 |
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Medicare Enrollment ID | O20070417000195 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710900808 | NPI | - | NPPES |
38390400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Provider Name | Andrew J Kramer |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1144259581 PECOS PAC ID: 2163526047 Enrollment ID: I20070403000027 |
Provider Name | Geoffrey R Warda |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1588699664 PECOS PAC ID: 8123123395 Enrollment ID: I20070614000360 |
Provider Name | Mark K Jackson |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1598788796 PECOS PAC ID: 6305941576 Enrollment ID: I20070618000206 |
Provider Name | Kim J Pansegrau |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1518990167 PECOS PAC ID: 0941305114 Enrollment ID: I20070712000018 |
Provider Name | Rhys P Strasia |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1629240296 PECOS PAC ID: 9638310436 Enrollment ID: I20130719000649 |
Provider Name | Tj A Dyer |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1376809129 PECOS PAC ID: 6901038066 Enrollment ID: I20160610000329 |
Provider Name | Scott R Goldberg |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1457693772 PECOS PAC ID: 0143451385 Enrollment ID: I20180606000250 |
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