National Provider Identifier Database

OCONOMOWOC DENTAL ANESTHESIA CENTER
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

OCONOMOWOC DENTAL ANESTHESIA CENTER
888 THACKERAY TRL STE 214
OCONOMOWOC, WI53066-4342
Phone: 262-567-9116
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for OCONOMOWOC DENTAL ANESTHESIA CENTER

NPI Number 1053972661
Legal business name
LBN
OCONOMOWOC DENTAL ANESTHESIA CENTER
Authorized official HENRY HOPKINSON - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 06/25/2019
Last updated 06/25/2019 - About 7 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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