NPI 1184016933

Puja J Bhakta, DDS

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Green Bay, WI

Practice location

Address: 430 Main St, Green Bay, WI 54301-5115
Phone: (920) 431-0345
Mailing address: 11711 W Burleigh St, Wauwatosa, WI 53222-3196

Registered specialties

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

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 1001499 (WI)

Other Oral & Maxillofacial Surgery providers in Wisconsin →

Registry record

NPI: 1184016933
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Mar 2015
Record last updated: 28 Aug 2023

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.