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Great Lakes Oral & Maxillofacial Surgery, P.a.
Oral and Maxillofacial Surgery (Dentist) in New Richmond, Wisconsin
NPI 1205136074

Great Lakes Oral & Maxillofacial Surgery, P.a. is a Oral and Maxillofacial Surgery (Dentist) based in New Richmond, WI and is specialized in Oral and Maxillofacial Surgery. Great Lakes Oral & Maxillofacial Surgery, P.a. practices in New Richmond, WI. The NPI Number for Great Lakes Oral & Maxillofacial Surgery, P.a. is 1205136074 and holds a License No. 4482 (Wisconsin).

The current practice location address for Great Lakes Oral & Maxillofacial Surgery, P.a. is 227 Meridian Dr # 6, New Richmond, WI and can be reached out via phone at 715-246-5150 and via fax at 715-246-5102.

Location: 227 Meridian Dr # 6, New Richmond, WI, 54017-2565
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1205136074
Provider Name
Great Lakes Oral & Maxillofacial Surgery, P.a.
Credential
Provider Entity Type
Organization
Address
227 Meridian Dr # 6, New Richmond, WI, 54017-2565
Phone Number
715-246-5150
Fax Number
715-246-5102
Provider Enumeration Date
10/27/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
227 Meridian Dr # 6
City
New Richmond
State
Wisconsin
Zip
54017-2565
Phone Number
715-246-5150
Fax Number
715-246-5102
person
Provider Business Mailing Address Details
Address
227 Meridian Dr # 6
City
New Richmond
State
Wisconsin
Zip
54017-2565
Phone Number
715-246-5150
Fax Number
715-246-5102
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
4482 (Wisconsin)
Definition
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.
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