Central Wisconsin Oral and Facial Surgery, LLC
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Antigo, WI
NPI 1477065787 · NPPES record last updated Oct 26, 2017
Key facts
- NPI
- 1477065787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 5831-15 (WI)
- Legal business name
- CENTRAL WISCONSIN ORAL AND FACIAL SURGERY, LLC
- Practice address
- 438 Edison St
Antigo, WI 54409-1845 - Phone
- (715) 432-4565
- NPI assigned
- Oct 26, 2017
- Organization subpart
- No
Authorized official
- Name
- Paulette Wright
- Title
- Manager
- Phone
- (843) 525-0900
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | 5831-15 | WI | Yes |
Addresses
Primary practice location
438 Edison St
Antigo, WI 54409-1845
Mailing address
968 Ribaut Rd Ste 3
Beaufort, SC 29902-8002
Phone (843) 525-0900
Other providers in Antigo, WI
- Angela Buchman
- Mark G Buchman
- Lynda Kay Buckner
- Bula Chiropractic LLC
- Stacy M Bula
- Emily Christianson
- City of Antigo
- Complete Dental Center, S.C.
- Cornerstone Chiropractic of Antigo LLC
- County of Langlade
All providers in Antigo, WI · Oral and Maxillofacial Surgery (Dentist) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.