| Northwoods Oral And Maxillofacial Surgery Sc | |
|
9762 West Lake Avenue Minocqua WI 54548 | |
| (715) 358-3321 | |
| Not Available |
| Full Name | Northwoods Oral And Maxillofacial Surgery Sc |
|---|---|
| Speciality | Dentist |
| Location | 9762 West Lake Avenue, Minocqua, Wisconsin |
| Authorized Official Name and Position | John Michael Kosmen (DENTIST) |
| Authorized Official Contact | 7153583321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwoods Oral And Maxillofacial Surgery Sc Po Box 1027 Minocqua WI 53548 Ph: (715) 358-3321 | Northwoods Oral And Maxillofacial Surgery Sc 9762 West Lake Avenue Minocqua WI 54548 Ph: (715) 358-3321 |
| NPI Number | 1346460441 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 09/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346460441 | NPI | - | NPPES |
| 33727700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4694 (Wisconsin) | Primary |
Rasmussen Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9792 Hwy 70, Minocqua, WI 54548 Phone: 715-358-9994 Fax: 715-358-9997 |