| Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.c. | |
|
4811 S 76th St Suite 304 Greenfield WI 53220-4364 | |
| (414) 281-3344 | |
| (414) 281-1080 |
| Full Name | Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4811 S 76th St, Greenfield, Wisconsin |
| Authorized Official Name and Position | Ronald Henry Nellen (PRESIDENT) |
| Authorized Official Contact | 4142813344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.c. 4811 S 76th St Suite 304 Greenfield WI 53220-4364 Ph: (414) 281-3344 | Oral & Maxillofacial Surgery Consultants Of Wisconsin, S.c. 4811 S 76th St Suite 304 Greenfield WI 53220-4364 Ph: (414) 281-3344 |
| NPI Number | 1285649921 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285649921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2699 (Wisconsin) | Primary |
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