ORAL SURGERY ASSOC LTD; NPI #1013020866

Contact Information

ORAL SURGERY ASSOC LTD

464 SOUTH HICKORY STREET
SUITE A
FOND DU LAC, WI 54935

Phone: 920-923-0111
Fax: 920-923-0366
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral & Maxillofacial Surgery	204E00000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for ORAL SURGERY ASSOC LTD

NPI # 1013020866

LBN Legal business name ORAL SURGERY ASSOC LTD

Authorized official GUY JENSEN - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/16/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

WI	License #	5000111-015
WI	License #	5001856-015

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ORAL SURGERY ASSOC LTD

Contact Information

Specialty

Oral & Maxillofacial Surgery

NPI Profile & details for ORAL SURGERY ASSOC LTD

Reviews for ORAL SURGERY ASSOC LTD