| Premier Oral & Maxillofacial Surgery S.c. | |
|
1602 N Randall Ave Janesville WI 53545-1124 | |
| (608) 756-8744 | |
| (608) 756-5344 |
| Full Name | Premier Oral & Maxillofacial Surgery S.c. |
|---|---|
| Speciality | Dentist |
| Location | 1602 N Randall Ave, Janesville, Wisconsin |
| Authorized Official Name and Position | Crystal M Dieter (MANAGER) |
| Authorized Official Contact | 6087568744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Oral & Maxillofacial Surgery S.c. 1602 N Randall Ave Janesville WI 53545-1124 Ph: (608) 756-8744 | Premier Oral & Maxillofacial Surgery S.c. 1602 N Randall Ave Janesville WI 53545-1124 Ph: (608) 756-8744 |
| NPI Number | 1992806269 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 06/11/2012 |
| Medicare PECOS PAC ID | 7315993714 |
|---|---|
| Medicare Enrollment ID | O20050329000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992806269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5E10250 (Wisconsin) | Primary |
| Provider Name | Jason J Swantek |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033200118 PECOS PAC ID: 5395910855 Enrollment ID: I20111212000401 |
| Provider Name | Richard D Meister |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1790886208 PECOS PAC ID: 0840246245 Enrollment ID: I20120404000177 |
| Provider Name | Kevin C Gams |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1518228816 PECOS PAC ID: 4688938962 Enrollment ID: I20180515000005 |
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Winter & Winter Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2203 Holiday Dr, Janesville, WI 53545 Phone: 608-752-2931 | |
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