| Greater Milwaukee Oral Surgery, Llc | |
|
6800 West Layton Avenue Greenfield WI 53220-4364 | |
| (414) 281-3344 | |
| (414) 281-1080 |
| Full Name | Greater Milwaukee Oral Surgery, Llc |
|---|---|
| Speciality | Dentist |
| Location | 6800 West Layton Avenue, Greenfield, Wisconsin |
| Authorized Official Name and Position | Robert John Goeckermann (OWNER) |
| Authorized Official Contact | 4142813344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Milwaukee Oral Surgery, Llc 6800 West Layton Avenue Greenfield WI 53220-4364 Ph: (414) 281-3344 | Greater Milwaukee Oral Surgery, Llc 6800 West Layton Avenue Greenfield WI 53220-4364 Ph: (414) 281-3344 |
| NPI Number | 1720569783 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 08/30/2023 |
| Medicare PECOS PAC ID | 6305179649 |
|---|---|
| Medicare Enrollment ID | O20190531000985 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720569783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5910-15 (Wisconsin) | Primary |
| Provider Name | Robert J Goeckermann |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1356504096 PECOS PAC ID: 7810148541 Enrollment ID: I20121106000463 |
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