Organization · Type 2 NPI

Kenosha Oral Surgery, S.c.

Oral and Maxillofacial Surgery (Dentist) · Kenosha, WI

NPI number 1710160486 Active

Practice location

6707 39th Ave
Kenosha, WI 53142-7125

Fax (262) 658-0276

Mailing address

4707 Washington Rd
Kenosha, WI 53144-1597

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X4998015 (WI)

Oral and Maxillofacial Surgery (Dentist): 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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About NPI 1710160486

Kenosha Oral Surgery, S.c.'s National Provider Identifier is 1710160486, issued on Dec 17, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Kenosha, WI. The record was last updated on Jun 2, 2022.