NPI 1083891261

Gregory A. Santarelli DDS Sc

Organisation Oral and Maxillofacial Surgery (Dentist) Kenosha, WI

Practice location

Address: 5017 Green Bay Rd STE 138, Kenosha, WI 53144-1782
Phone: (262) 654-6770
Fax: (262) 654-6727

Authorised official

Name: Patricia R Lee
Title: Office Manager
Phone: (262) 654-6770

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 5188015 (WI)

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Registry record

NPI: 1083891261
Entity type: Organization
NPI issued: 30 Jan 2008
Record last updated: 5 Oct 2009

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.