| Northern Oral & Maxillofacial Surgeons, Pa | |
|
503 Belknap St Superior WI 54880-2932 | |
| (715) 564-4081 | |
| (715) 564-4083 |
| Full Name | Northern Oral & Maxillofacial Surgeons, Pa |
|---|---|
| Speciality | Dentist |
| Location | 503 Belknap St, Superior, Wisconsin |
| Authorized Official Name and Position | Timothy Lee Morse (ORAL SURGEON) |
| Authorized Official Contact | 2187228377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Oral & Maxillofacial Surgeons, Pa 503 Belknap St Superior WI 54880-2932 Ph: (715) 564-4081 | Northern Oral & Maxillofacial Surgeons, Pa 503 Belknap St Superior WI 54880-2932 Ph: (715) 564-4081 |
| NPI Number | 1013068691 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 02/23/2021 |
| Medicare PECOS PAC ID | 3072535863 |
|---|---|
| Medicare Enrollment ID | O20060327000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013068691 | NPI | - | NPPES |
| 38393500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Peter J Mayer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1104976570 PECOS PAC ID: 1951323732 Enrollment ID: I20060327000269 |
| Provider Name | Marty J Espe |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760532139 PECOS PAC ID: 7911915376 Enrollment ID: I20140102001087 |
| Provider Name | Timothy Lee Morse |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1225264575 PECOS PAC ID: 0547409179 Enrollment ID: I20141006000781 |
| Provider Name | Duncan R Puffer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073663449 PECOS PAC ID: 6002824463 Enrollment ID: I20151001000066 |
| Provider Name | Benjamin T Heggestad |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598146763 PECOS PAC ID: 5294047569 Enrollment ID: I20210810001059 |
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