National Provider Identifier Database

WISCONSIN ORAL MAXILLOFACIAL SURGERY LLC
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

WISCONSIN ORAL & MAXILLOFACIAL SURGERY LLC
2603 W RAWSON AVE STE 123
OAK CREEK, WI53154-8422
Phone: 914-325-5672
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X
Dental 261QD0000X

* Indicates primary specialty

NPI Profile & details for WISCONSIN ORAL & MAXILLOFACIAL SURGERY LLC

NPI Number 1013409002
Legal business name
LBN
WISCONSIN ORAL & MAXILLOFACIAL SURGERY LLC
Authorized official EJLAL ALALAWI - (OWNER/PROVIDER)
Entity Organization
Organization subpart No
Enumeration date 06/05/2018
Last updated 06/05/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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