NPI 1013020866

Oral Surgery Assoc LTD

Organisation Oral & Maxillofacial Surgery (D.M.D.) Fond Du Lac, WI

Practice location

Address: 464 South Hickory Street Suite a, Fond Du Lac, WI 54935
Phone: (920) 923-0111
Fax: (920) 923-0366

Authorised official

Name: Guy K Jensen
Title: Owner
Phone: (920) 923-0111

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 5000111-015 (WI)

Other Oral & Maxillofacial Surgery providers in Wisconsin →

Oral & Maxillofacial Surgery (D.M.D.)

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 5001856-015 (WI)

Registry record

NPI: 1013020866
Entity type: Organization
NPI issued: 16 Aug 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.