Lake Geneva Oral And Maxillofacial Surgery, Ltd | |
312 Center St Lake Geneva WI 53147-1904 | |
(262) 248-8766 | |
(262) 248-6790 |
Full Name | Lake Geneva Oral And Maxillofacial Surgery, Ltd |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 312 Center St, Lake Geneva, Wisconsin |
Authorized Official Name and Position | Adam Ozment (PRESIDENT) |
Authorized Official Contact | 2622488766 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Geneva Oral And Maxillofacial Surgery, Ltd 312 Center St Lake Geneva WI 53147-1904 Ph: (262) 248-8766 | Lake Geneva Oral And Maxillofacial Surgery, Ltd 312 Center St Lake Geneva WI 53147-1904 Ph: (262) 248-8766 |
NPI Number | 1063420206 |
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Provider Enumeration Date | 08/03/2006 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
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1063420206 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Wisconsin) | Primary |
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